DLA prophylaxis in patients with lymphatic insufficiency- 30 years of follow-up

Introduction. The lymphatic system in limbs and organs serves detection, transport away, and neutralize microorganisms penetrating integuments. Obstruction of lymphatics pathways brings about tissue fluid/lymph stasis and subsequently retention of microorganisms continuously penetrating sole and hand skin. These microbes proliferate in the lymphedematous tissues and evoke the host's immune reaction. The inflammatory condition is called dermato-lymphangio-adenitis (DLA). Acute episodes of DLA occur in 50%, and a chronic process is observed in 95% of lymphedema cases. Each episode of DLA is commonly followed by worsening of leg swelling. Chronic bacterial prophylaxis is necessary Aim. To follow the effects of lasting for years continuous no-break administration of benzathine penicillin on recurrence of acute DLA episodes.Material and Methods. Two hundred thirty-one patients with lower and upper limb lymphedema appearing in our OPD between 1990 and 2020 were included. The mean duration of lymphedema was 10.2 ±7.3 (2-30) years. The total number of DLA episodes was 805. Benzathine penicillin injections 1,200,000 units were given i.m. every 14–21 days (mean 18 – 9 days). The period of therapy was 39.2 ±38.7 (median 32) months.Results. Acute DLA occurred in 23 out of 231 (10%) ( p