Institute of Applied Dermatology pioneers in producing an integrative treatment protocol for treating lymphedema effectively. At IAD we treat all types of Lymphedema.
The most common cause for lymphedema, in India, is Lymphatic Filariasis. Filariasis is a major public health problem throughout many regions of the tropics. Lymphatic Filariasis is a debilitating disease involving the lymphatic system. Lymphatics play a vital role in maintaining the immune system. Malfunctioning or obstruction of lymphatic system results in lymphedema and impairment of its physiological functions. Filariasis is an infection caused by a mosquito: an infected mosquito bites a human and deposits microscopic larvae (microfilaria) into the skin. The larvae migrate to the nearest lymph vessel in the unsuspecting human and then on to the bigger lymph vessels close to the lymph glands where they mature into adult worms. They mate and form worm nests, which physically block the flow of lymph within the vessel, and so lymphoedema starts. Not all people infected with lymphatic Filariasis develop lymphedema but when they do the swelling can be so severe, and the skin changes so discernibly, it is called ‘elephantiasis’.
People are only affected by Filariasis in regions with infected mosquitoes and that means a tropical country. Arguably India has more cases of lymphoedema than any other country on the planet because of the high numbers of cases of lymphatic filariasis. As well as swelling, the disease also causes frequent fevers as the body fights the worm infection. Eventually the fevers cease, when the worms die, but by then the lymph system has likely been permanently damaged. Then the fevers might start again but this time due to bacterial infection. This is now just the same as with any form of lymphoedema, where the sufferer develops recurrent bouts of bacterial infection, equivalent to cellulitis but called acute dermatolymphangio adenitis or ADLA. With each episode of infection, the swelling gets worse, often reaching gigantic proportions.
Fig1: Classification of Lymphoedema based on the aetiology (cause )
Integrative treatment approach of chronic dermatological cases at our institute
The schematic diagram gives an overview of how integrated treatment is provided in IAD
Fig2: Integrative treatment approach of chronic dermatological cases at our institute
The flow of integrative treatment for Lymphoedema
- It starts with a session of counselling
- Examination by doctors and deciding on the treatment protocol
- Blood and Urine Investigations
- Photo Documentation,
- Volume Measurement,
- Girth Measurement-done to monitor the treatment outcomes
- Duration of stay depends on the on the disease and associated complications. It ranged from 7-28 days
- Out-patient day-care-daily treatment lasts for 2 to 3 hours
- Treatment training of at least one member of the family on self-care and how to support the patient back at home
- Patient follow up after 30th and 60th days of discharge and periodically after that
- Patients continues treatment
- IAD supervision through WhatsApp is available on long term home-based self-care
- The treatment components and duration may get simplified depending on the improvement of the affected limb