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gradually (Figure 2.a and 2.b). In this aytpical and very rare case we aimed to report the short term relative efficacy of complex decongestive therapy in such a young child. The family was educated for the risk reduction methods for complications of lymphedema and manual lymphatic drainage as well as bandaging. They were also instructed for follow-up visits. A pressure garment was planned for the control visit, 6 months later.
Most forms of primary lymphedema are thougt to be caused by a congenital abnormality of the lymphatic system (1). Primary lymphedema is a rare disease; prevelance ranges within 1:6.000 to 1:10.000 (2). It is seen more in females. The most frequent clinical presentation is swelling of the leg and ankle. However upper extremity may also be affected in congenital lymphedema (3).
Fig. 2.a
Fig. 2.b
Complex decongestive therapy which has individual components of skin care, manual lymph drainage, compression bandages, exercise and pressure garments, is the golden standard treatment for reducing both primary and secondary lymphedema (4).
In this case we aimed to indicate the short term effects of manual lymphatic drainage and multilayer bandaging in the right extremity. Although the regression of abdominal distention seems to be due to the parenteral nutrition with specific diet, we believe that kinesio taping may make even a little contribution.
Sincerely
Gökhan Çağlayan, MD Specialist of PRM
REFERENCES
1. Sukulal K, Namboodiri N.: Congenital lymphedema: another unique and gender specific stigmata of tuberous sclerosis? Indian Pediatr, 2012; 49: 845.
2. Rockson S.G.: Lympedema:Evaluation and decision making. In: Cronentwett J.L., Johnston K.W. (eds.), “Rutheford’s vascular surgery”, 7th edition, Vol. 1. Philadelphia: Saunders Elsevier 2010; 1004-16.
3. Mala J. et al.: A rare clinical manifestation of lymphedema of praecox affecting the upper extremity. Vasa, 2013; 42: 218-22.
4. Lasinski B.B., McKillip Thrift K., Squire D. et al.: A systematic review of the evidence for complete decongestive therapy in the treatment of lymphedema from 2004 to 2011. PM R. 2012 Aug; 4(8): 580-601.
THE EUROPEAN JOURNAL OF LYMPHOLOGY - Vol. XXIX - Nr. 75 - 2017
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