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Elephantiasis

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Elephantiasis is a condition characterized by gross enlargement of an area of the body, especially the limbs and occasionally the external genitals. Elephantiasis is caused by obstruction of the lymphatic system, which results in the accumulation of a fluid called lymph in the affected areas. Elephantiasis is also known as Lymphatic Filariasis. In areas where Filariasis (infectious, tropical disease caused by roundworms) is epidemic, Elephantiasis is most common.
The Lymphatic System is a network of tissues and organs that help rid the body of toxins, waste and other unwatend materials. The primary function of the Lymphatic System is to transport lymph, a fluid containing infection-fihgting white blood cells throughout the body. It consists of a network of tubular channels (lymph vessels) that drain lymph from different areas of the body into the bloodstream. When obstruction occurs, these vessels swell massively, causing gross enlargement, also known as Elephantiasis. Elephantiasis is also a chronic infectious condition that affects the skin and subcutaneous tissues. It is a very rare disorder, and is most common in tropical countries.
Elephantiasis most frequently involves the lower extremities of the body and the scrotum. The most common affected area on the body is the legs. It can also affect the arms, the breasts, the scrotum, the penis and the vulva. Elephantiasis gets its name from the obvious appearance of the skin of the legs which resembles the hide of an elephant. The sign of elephantiasis is usually the extreme grotesque swelling of the lymph nodes and other limbs. The main symptom of elephantiasis is gross enlargement and swelling of an area of the body because of the accumulation of fluid. The arms and legs are the area’s most often affected. An entire arm or leg may swell to several times its normal size resembling the thick, round appearance of an elephant’s leg. The skin of the affected areas usually develops a dry, thickened, rocky appearance and may develop hyperkeratosis. Fever, chills, and malaise may also be present as well.
Elephantiasis may also affect the male and female external genital organs. In a male, there may be enlargement of the scrotum, and the penis may be retracted under skin which has become thickened, loss of elasticity, hot and painful. The spermatic cords may thicken as well. A burning sensation may occur as well during urination and ejaculation. The external parts of the female genital organs (vulva) may also be affected by elephantiasis. A tumorous mass covered by thickened and ulcerated skin may develop between the thighs and may be accompanied by enlarged lymph nodes (lymphadenopathy) of the legs. In some women the breasts may become enlarged as well. Underlying damage to the lymphatic system may leave individuals susceptible to secondary bacterial and fungal infections that can greatly worsen the condition. Although the legs, arms and external genitalia are most often affected, elephantiasis can affect any area of the body.
Elephantiasis is caused by obstruction of the lymph vessels of the lymphatic system. In underdeveloped regions of South America, Central Africa, Asia, the Pacific Islands and the Caribbean, obstruction can be caused by a parasitic disease known as Lymphatic Filariasis. Lymphatic Filariasis is caused by three different species of worms known as Brugia malayi, Brugia timori and Wuchereria bancrofti. These worms cause damage and inflammation to the lymphatic system. The larval form of the worms is introduced into the human body through the bite of infected mosquitoes. Genital elephantiasis can also be caused by bacterial sexually transmitted diseases, specifically Lymphogranuloma Venereum (LGV) and Donovanosis.
The standard method for diagnosing Elephantiasis is the identification of microfilariae in a blood smear by microscopic examination. The microfilariae that cause Lymphatic Filariasis circulate in the blood at night (called nocturnal periodicity). Blood collection should be done at night to match with the appearance of the microfilariae. Diethylcarbamazine (DEC) is used to kill the adult worms and microfilariae that cause Elephantiasis.

References
Elephantiasis. (2011). Retrieved July 09, 2016, from WebMD, http://www.webmd.com/a-to-z-guides/elephantiasis
Zimmermann, K. A. (2016, March 11). Lymphatic System. Retrieved July 09, 2016, from LiveScience, http://www.livescience.com/26983-lymphatic-system.html
WHO. (2016, March 9). Lymphatic filariasis. Retrieved July 09, 2016, from World Health Organization, http://www.who.int/mediacentre/factsheets/fs102/en/
CDC. (2010, August 15). Lymphatic Filariasis - prevention & control. Retrieved July 09, 2016, from Centers for Disease Control and Prevention, http://www.cdc.gov/parasites/lymphaticfilariasis/prevent.html…...

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