S Reich-Schupke1, E Mohren2, M Stücker2. 1. Venenzentrum der Dermatologischen und Gefäßchirurgischen Kliniken, Klinik für Dermatologie, Venerologie und Allergologie, Ruhr-Universität Bochum, Gudrunstr. 56, 44791, Bochum, Deutschland. Stefanie.Reich-Schupke@rub.de. 2. Venenzentrum der Dermatologischen und Gefäßchirurgischen Kliniken, Klinik für Dermatologie, Venerologie und Allergologie, Ruhr-Universität Bochum, Gudrunstr. 56, 44791, Bochum, Deutschland.
Abstract
BACKGROUND: Implementation of guideline recommendations for the diagnosis and therapy of lipedema and lymphedema seems to be problematic in daily routine. Systematic data for Germany are missing. The aim of the study was data collection regarding diagnosis and therapy of lymphologic diseases in an outpatient setting. METHODS: Monocentric, prospective survey of patients from a lymphologic outpatient clinic using a standardized questionnaire focusing on diagnostics and therapy at the initial diagnosis. RESULTS: In all, 72 patients (83.3% women) with lymphedema (n = 26), lipedema (n = 14) or lipolymphedema (n = 32) were included; 44.4% had symptoms more than 5 years before the initial diagnosis. Main symptoms were swelling of the leg and foot (especially lymphedema) and feeling of heaviness (especially lipedema). In 75%, the initial diagnosis was made by a medical specialist. The basic diagnostics recommended by the guidelines-medical history (73.6%) and clinical examination (84.7%)-were done in most of the patients. After the initial diagnosis, 46% of the patients had decongestion therapy of different intensity and quality. A total of 58.3% of the patients were directly provided a prescription for a medical stocking. Only a few patients received instructions for breathing exercises (22.2%), self-performed lymphatic drainage (6.9%) or muscle exercises (8.3%). DISCUSSION: There are still deficits in the diagnosis and especially in the therapy of patients with lymphologic diseases in an outpatient setting. Further education and training are necessary for physicians, physiotherapists, medical supply businesses, and patients.
BACKGROUND: Implementation of guideline recommendations for the diagnosis and therapy of lipedema and lymphedema seems to be problematic in daily routine. Systematic data for Germany are missing. The aim of the study was data collection regarding diagnosis and therapy of lymphologic diseases in an outpatient setting. METHODS: Monocentric, prospective survey of patients from a lymphologic outpatient clinic using a standardized questionnaire focusing on diagnostics and therapy at the initial diagnosis. RESULTS: In all, 72 patients (83.3% women) with lymphedema (n = 26), lipedema (n = 14) or lipolymphedema (n = 32) were included; 44.4% had symptoms more than 5 years before the initial diagnosis. Main symptoms were swelling of the leg and foot (especially lymphedema) and feeling of heaviness (especially lipedema). In 75%, the initial diagnosis was made by a medical specialist. The basic diagnostics recommended by the guidelines-medical history (73.6%) and clinical examination (84.7%)-were done in most of the patients. After the initial diagnosis, 46% of the patients had decongestion therapy of different intensity and quality. A total of 58.3% of the patients were directly provided a prescription for a medical stocking. Only a few patients received instructions for breathing exercises (22.2%), self-performed lymphatic drainage (6.9%) or muscle exercises (8.3%). DISCUSSION: There are still deficits in the diagnosis and especially in the therapy of patients with lymphologic diseases in an outpatient setting. Further education and training are necessary for physicians, physiotherapists, medical supply businesses, and patients.
Authors: Stefanie Reich-Schupke; Wilfried Schmeller; Wolfgang Justus Brauer; Manuel E Cornely; Gabriele Faerber; Malte Ludwig; Gerd Lulay; Anya Miller; Stefan Rapprich; Dirk Frank Richter; Vivien Schacht; Klaus Schrader; Markus Stücker; Christian Ure Journal: J Dtsch Dermatol Ges Date: 2017-07 Impact factor: 5.584