Lymphedema is a chronic condition characterized by edema, which is usually localized in the limbs, trunk and genitalia.The World Health Organization estimates that 45 million people have symptoms associated with lymphedema. Recent literature has focused on the treatment of massive localized lymphedema in morbidly obese patients. Lymphedema associated with obesity is most commonly localized in the lower limbs and the abdominal pannus. Swelling induces chronic venous insufficiency.Venous return is initially compensated for by the lymphatic system but continual overload results in lymphatic failure and gives rise to venous and lymphatic edema. Localized lymphedema in obese patients results in numerous symptoms associated with skin breakdown. Therefore, managing and understanding the pathology of lymphedema has become increasingly relevant and important in improving the quality of life in the morbidly obese.
The reduction of lymphatic drainage induces a build up of inflammatory mediators in the skin.The accumulation of immune proteins and cytokines, in addition to venous and lymphatic edema, results in skin/barrier dysfunction8. Improper skin/barrier function eventually leads to infection, erythema and dermatitis.The outermost layer of the skin, the stratum corneum consists of epidermal cell remnants and metabolically active lipids.These skin layers require nourishment and protection to reduce problematic symptoms associated with localized lymphedema.
To determine if a skin care regimen using Olivamine containing skin care products could reduce skin breakdown, pain, odor and pruritus in the morbidly obese with lymphedema.
Nine morbidly obese patients, with lymphedema, were evaluated over an approximate six month period.The lymphedema presented on the lower extremities or abdominal pannus. Four criteria, including dry/flaky/scaly skin, erythema, fungal component, and maceration along with pain, odor and pruritus were evaluated on an initial physician visit. Final physician evaluations were noted for each patient. All patients were treated in the office and then given Olivamine containing products for self-care. Patient protocols were based on the location of the lymphedema and their symptoms.
Lymphedema is the accumulation of lymphatic fluid in the interstitial tissue, causing swelling. Lymphedema can develop when lymphatic vessels are missing or impaired; or when lymph nodes removed, such as during surgery for cancer. It may develop as a result of surgery, radiation, infection or trauma. Lymphedema may be caused by the weight of a fat apron, the excessive pressure congesting the lymph and blood vessels of the lower abdomen. Patients will note swelling, darkened skin, hardening and thickened abdominal tissue, dryness, fissures, itching, pain, and development of warty growths or ‘papillomatosis’.They may note development of ulcers in the skin folds and in traumatized areas: and inability to get ulcers in the damaged skin to heal.
In our clinic, we see a number of morbidly obese patients with lymphedema.They all report dry, itchy, scaly, painful skin. Clinically, they present with indurated, congested skin, with varying degrees of peau ‘de orange and papillomatosis.This firm, but delicate skin is prone to injury and ulceration, particularly in the creases and around the papillomas.We have found success with the consistent use of Olivamine containing skin care products.
The line of products we use contain Olivamine, a blend of ingredients including antioxidants, amino acids, vitamins, and methylsulfonylmethane.These ingredients help to nourish skin with everything it needs to atttain and maintain health.These products soothe the pain and itching, promotes healthy skin at the edge of wounds and ulcerations, thus promoting a healthy epithelial edge for improved wound healing. We will continue to utilize Olivaminecontaining skin care products in our clinic to promote healthy skin, to reduce the risk of sores and ulcerations, and improve quality of life.