Lower limb lymphedema mimicking as elephantiasis in intravenous drug user

Authors

  • Shubham Aryan Department of Medicine, Guru Gobind Singh Medical College and Hospital, Faridkot, Punjab, India
  • Mandeep Singh Department of Medicine, Guru Gobind Singh Medical College and Hospital, Faridkot, Punjab, India
  • Chavi Sharma Department of Medicine, Guru Gobind Singh Medical College and Hospital, Faridkot, Punjab, India
  • Himanshu Khutan Department of Medicine, Guru Gobind Singh Medical College and Hospital, Faridkot, Punjab, India
  • Jasmeen Chahal Department of Medicine, Guru Gobind Singh Medical College and Hospital, Faridkot, Punjab, India
  • Naveen Kumar Department of Medicine, Guru Gobind Singh Medical College and Hospital, Faridkot, Punjab, India

DOI:

https://doi.org/10.18203/2349-3933.ijam20241023

Keywords:

Unilateral lymphedema, IV drug abuse, Elephantiasis

Abstract

India been the population of over a billion, it is estimated that 62.5 million people use alcohol, 8.75 million use cannabis, two million use opiates, and 0.6 million use sedatives or hypnotics. Intravenous (IV) drug abuse is fairly spreading throughout the country. Rapid urbanization and migration to metro cities have led to disturbance in the social life render an individual more vulnerable to stresses and strain of modern life and with easy availability of drugs, sharing needle, peer pressure are also among the commonest reason for exponential rise of intravenous drug user (IVDU) especially among the young generation. IV drug abuse is one of most serious and social evil, prevailing in our society that leads to number of infections from local cutaneous infections to dreadful like human immuno-deficiency virus (HIV) which in turn not only increase the morbidity but mortality as well. Here we have patient who had history of IV drug injection to lower limb that led to chronic lower limb swelling which on further investigation turns out to be grade IV lymphedema.

References

Sharma B, Arora A, Singh K, Singh H, Kaur P. Drug abuse: Uncovering the burden in rural Punjab. J Family Med Prim Care. 2017;6(3):558-62.

Nadeem A, Rubeena B, Agarwal VK, Kalakoti P. Substance abuse in India. Pravara Med Rev. 2009;1(4):4-6.

Tse JY, Adisa M, Goldberg LJ, Nazarian RM. Dermatopathologic manifestations of intravenous drug use. J Cutan Pathol. 2015;42(11):815-23.

Aslam A, Rather S, Hussain A, Younus F, Saqib NU, Hassan I. Prevalence and Pattern of Dermatological Manifestations Among Substance Users Across Kashmir Valley in North India. Indian Dermatol Online J. 2022;13(4):457-65.

Lavender TW, McCarron B. Acute infections in intravenous drug users. Clin Med (Lond). 2013;13(5):511-3.

Grada AA, Phillips TJ. Lymphedema: Pathophysiology and clinical manifestations. J Am Acad Dermatol. 2017;77(6):1009-20.

Andraska EA, Horne DC, Campbell DN, Eliason JL, Wakefield TW, Coleman DM. Patterns of pediatric venous disease. J Vasc Surg Venous Lymphat Disord. 2016;4(4):422-5.

Cazzolla AP, Lo Muzio L, Di Fede O, Lacarbonara V, Colaprico A, Testa NF, et al. Orthopedic-orthodontic treatment of the patient with Turner's syndrome: Review of the literature and case report. Spec Care Dentist. 2018;38(4):239-48.

Slater HC, Gambhir M, Parham PE, Michael E. Modelling co-infection with malaria and lymphatic filariasis. PLoS Comput Biol. 2013;9(6):e1003096.

King B. Diagnosis and management of Lymphedema. 2006;102(13):47-51.

Ridner SH. Pathophysiology of Lymphedema. Semin Oncol Nurs. 2013;29(1):4-11.

Sleigh BC, Manna B. Lymphedema. Statpearls - NCBI bookshelf. 2023.

Gasparis AP, Kim PS, Dean SM, Khilnani NM, Labropoulos N. Diagnostic approach to lower limb edema. Phlebology. 2020;35(9):650-5.

Ely JW, Osheroff JA, Chambliss ML, Ebell MH. Approach to leg edema of unclear etiology. J Am Board Fam Med. 2006;19(2):148-60.

Barton M, Fett N. Red puffy hand syndrome mistaken for inflammatory arthritis. Dermatol Online J. 2020;26.

Chouk M, Vidon C, Deveza E, Verhoeven F, Pelletier F, Prati C, Wendling D. Puffy hand syndrome. Joint Bone Spine. 2017;84:83-5.

Del Giudice P. Cutaneous complications of intravenous drug abuse. Br J Dermatol. 2004;150(1):1-10.

Mutluer FO. Unilateral leg edema: Is it always vascular? Arch Turk Soc Cardiol. 2018;706-9.

Malgor RD, Labropoulos N. Diagnosis of venous disease with duplex ultrasound. Phlebology. 2013;1:158-61.

Garcia R, Labropoulos N. Duplex ultrasound for the diagnosis of acute and chronic venous diseases. Surg Clin North Am. 2018;98:201-18.

Saleem T, Knight A, Raju S. Diagnostic yield of intravascular ultrasound in patients with clinical signs and symptoms of lower extremity venous disease. J Vasc Surg Venous Lymphat Disord. 2020;8:634-9.

Rockson SG. Current concepts and future directions in the diagnosis and management of lymphatic vascular disease. Vasc Med. 2010;15:223-31.

Tiwari A, Cheng KS, Button M, Myint F, Hamilton G. Differential diagnosis, investigation, and current treatment of lower limb lymphedema. Arch Surg. 2003;138(2):152-61.

Papadopoulou MC, Tsiouri I, Salta-Stankova R, Drakou A, Rousas N, Roussaki-Schulze AV, et al. MultidisciplinaryLymphedema treatment program. Int J Low Extrem Wounds. 2012;11:20-7.

Zuther JE, Norton S, editors. Lymphedema Management: The Comprehensive Guide for Practitioners. 3rd edition. Sttuttgard: Thieme Verlag KG. 2013;165-342.

Downloads

Published

2024-04-26

Issue

Section

Case Reports