Podoconiosis

Question 1

Podoconiosis - definition

Answer 1

Non-infectious neglected tropical disease characterised by steadily progressive foot and leg swelling [lymphoedema]
-Commonly confused with lymphatic filariasis

Question 2

Podoconiosis - cause

Answer 2

Not caused by any parasite, bacteria or virus

Triggered by a combination of factors:
-Exposure of irritant soil
-Genetic suscetibility [HLA-DQA1]
-Foot vulnerability

Question 3

Podoconiosis - epidemiology

Answer 3

Evidence in 17 countries - 12 countries in Africa

Question 4

Podoconiosis - age distribution

Answer 4

Rare before age 10

Question 5

Podoconiosis - gender distribution

Answer 5

F>M

Question 6

Podoconiosis - pathogenesis

Answer 6

Soil nanoparticles penetrate the skin of foot and are phagocytosed by macrophages in lymphatic system
Particles induce inflammatory reactions leading to fibrosis and blockage of the vessel lumen

Question 7

Podoconiosis - diagnosis

Answer 7

History and physical examination
Antigen and antibody tests to exclude lymphatic filariasis

Question 8

Podoconiosis - clinical features

Answer 8

Mainly bilateral - but can be unilateral
itching, burning, reversible plantar oedema, hyperkeratosis
Moss-like changes
Lymphoedema type:
-Waterbag 60%
-Fibrotic 30%
-Both 18%

Question 9

Podoconiosis - complications

Answer 9

Acute dermato-lymphangio-adenitis [ADLA]:
-Malaise, fever, diffuse inflammation and swelling, adenitis, lymphagitis

Ulcer - not responding to care

Deep fungal infection

Question 10

Podoconiosis - management

Answer 10

Hygiene
Skincare
Bandaging
Elevation
Footwear
Wound care