Lymphatic filariasis

Elephantiasis or Filariasis (Greek ελεφαντίασις, or even elephant man syndrome in about " the Elefantenartigkeit " of ὁ ἐλέφας, " the elephant ") is an abnormal enlargement of a body part by a lymphatic. Usually the legs or the external genitals are affected. This disease is particularly common in developing countries. A distinction is acquired from congenital forms.

Acquired forms

Sequence of infectious diseases

• The disease occurs as elephantiasis tropica mainly in tropical regions and is here as a late consequence of various infections, including by Brugia malayi nematodes as (also Wuchereria malayi or filaria malayi called ) or Wuchereria bancrofti, but also triggered by leprosy. The worms enter through the bite of a mosquito or other insect into the lymphatic system and cause a chronic inflammatory reaction with lymphatic congestion, resulting in time to an extreme enlargement and hardening of the skin.

As prophylaxis protection against mosquitoes by repellents or mosquito nets is recommended.

• The Elephantiasis can also be a complication of erysipelas occurring worldwide by an inflammatory destruction of the lymphatics.
• After repeated severe cases of cold sores, it can be used for so-called macrocheilia (Greek μακροχειλία, makrochilía, " big lips " ) can occur.

Other causes

• After severe superficial phlebitis with massive Gewebestauung
• Also, tumors can drag a elephantiasis itself, either directly by occlusion of lymphatic vessels by neoplastic Lymphmetastasen or indirectly as a side effect or necessary transportation of metastases in the context of therapy: in operative Splenic the lymphatics, eg as lasting arm swelling after breast cancer surgery
• During radiotherapy especially in cancer and therapy with Elephantiasisausbildung late there have been cases of secondary malignant tumors, which can be regarded as a complication of elephantiasis: These are usually fast-growing sarcomas, which are summarized under the term ' Stewart -Treves syndrome '. The only curative treatment option is radical as possible amputation of the affected limb; usually there are metastases at diagnosis, however, allow only a palliative ( palliative ) chemotherapy with cytotoxic drugs or palliative care.

Congenital forms

• As elephantiasis congenita hereditaria (Latin congenitus, " innate " and hereditarius, "inherited" ) is an evolving in infants swelling of those body parts are designated, the erblicherseits or have a developmental disability or not enough Lymphabflussbahnen.
• In the context of complex malformation syndromes such as neurofibromatosis

Treatment

The disease is not transferable. A true cure does not exist. Although the causes of Lymphstaus are irreversible in many cases, is the consistent application of manual lymph drainage several times a week and lasting wearing compression bandages or stockings, the external symptoms for many patients, reversible and easy to control. If the skin stretched, their original elasticity is hardly recovered. In question then comes a gathering of the skin and subcutaneous tissue in the context of plastic surgery, but which also can not completely reconstruct the original skin characteristics. Attempts spacious auszuschälen all jammed tissue, however, have proven in the past to be useless and, through the long-range scarring, as harmful.