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How can we manage LF?
As there are many different presentations of clinical disease related to LF, there is no single drug or treatment that is effective for all cases. However, for all patients, three issues should be considered 1) anti-parasitic drug therapy, 2) supportive clinical care and 3) patient education and counselling.
Anti-parasitic Drug Therapy
To prevent possible transmission of LF to others, patients with clinical disease are treated with a regimen of anti-parasitic drugs.
Supportive Clinical Care
Adult worms cause permanent damage to the lymphatic system. However, symptoms can be managed by reducing the frequency of acute attacks and stopping the disease from getting worse. Patients can easily learn hygiene measures that are effective in minimizing infection and promoting lymph flow.
These simple measures to be undertaken by the patient include:
Washing the affected parts twice daily with soap and clean, cool water, and drying carefully
Raising the affected limb at night
Exercising the limb regularly
Keeping the nails and spaces between the toes clean
Wearing comfortable shoes
Using medicated creams or antibiotics to treat small wounds or abrasions
Through these methods, even the worst case of elephantiasis can be improved over time.
For most hydrocele patients, surgery is the treatment of choice. Men have a good prognosis with early hydrocele and corrective surgery can be undertaken even with local anaesthetic. Quality pre- and post-operative care are important components that help make this surgery successful. For other genital damage, more complicated surgery is often required. For example, scrotal skin elephantiasis may require complex reconstructive surgery with skin grafts for real improvement. Unfortunately, however, hydrocele surgery is often too expensive for those afflicted with LF.
Patient Education and Counselling
Psychological counselling is also essential to support those patients with LF-induced disability who can suffer from acute shame, isolation, sexual dysfunction and intense chronic pain and suffering.