A swollen leg

A 39 year old subsistence farmer is referred to the dermatology clinic at QE Hospital Blantyre, Malawi, with massive left leg swelling that has been present for several years. His main complaint is of “leaking” and malodour, and he is reluctant to remove the Tubifast dressing that he has applied himself.

Case contributed by Levie Mwale and Ann Sergeant

Questions

  • What is the likely diagnosis?
  • What advice and treatment would you suggest?
Write what you think and what you'd do

Show the answer?

He has elephantiasis which is characterised by skin thickening and swelling of the underlying tissue leading to enlargement of his limb.  This is secondary to underlying problems with lymphatic drainage, and in this case the most likely cause is lymphatic filariasis.

The old bandages that he has applied should be removed and he should be shown/advised how to clean to reduce infection.  Emollients may be used to restore and maintain skin suppleness.

Further info

Last Updated on February 2, 2025 by admin