Sunday, January 31, 2016

USE OF MANUAL LYMPHATIC DRAINAGE THERAPY FOR THE RESOLUTION OF POST-INFLAMMATORY HYPERPIGMENTATION: A CASE REPORT


Background: Literature suggests that manual lymphatic drainage therapy (MLDT) can positively impact general skin complexion.  MLDT was selected as treatment for dark skin discolorations caused by post inflammatory hyperpigmentation (PIH).  Purpose: The purpose of this study is to observe MLDT in reducing PIH. Methods: MLDT was performed on two adult women for more than 2 ½ months. Skin was observed each session with photographs taken pre/post treatment.  Patient 1 had PIH related to leg flea bites and familial predisposition; Patient 2 had PIH from cystic acne at inner thighs. Each received 60-65 minute MLDT sessions, performed full body and locally on hyperpigmented areas.  Instruction in diaphragmatic breathing began day 1, with each educated about diet and water intake.  The Dermatology Life Quality Index (DLQI) was provided pre/post treatment. Frequency of treatment was individualized, patient 1 coming twice monthly for 4 months and patient 2 was weekly for 2 ½ months.  Outcomes:  Patient 1 had noticeable improvement in skin discoloration at 2 ½ months, with near complete resolution at 4 months. Patient 2 had partial resolution of skin discoloration at 2 ½ months.  Discussion:  Observable improvement in skin discoloration was seen in both cases, but longer duration treatment and habitual use of class 1 compression socks may explain the more complete resolution of PIH in patient 1. The DLQI deemed unnecessary by one patient, demonstrated improvement in the other, particularly in areas of clothing choice and intimacy. Conclusion: These findings suggest that MLDT may be a feasible non-invasive alternative for reducing PIH. 



References

Chakraborty, S., Zawieja, S., Wang, W. Zawieja, D. C., & Muthuchamy, M. (2010). Lymphatic system acts as a vital link between metabolic syndrome and inflammation.  Ann NY Acad Sci, 1207(Suppl 1).  doi:  10.1111/j.1749-6632.2010.05752.x

Chikly, B. (2001). Silent waves: Theory and practice of lymph drainage therapy. Palm Beach Gardens, FL: Upledger Institute, Inc.

Durai, P. C. T., & Nair, D. G. (2015). Acne vulgaris and quality of life among young adults in south India. Indian Journal of Dermatology, 60(1), 33-40. doi: 10.4103/0019-5154.147784

Jerajani, H. R., Mizoguchi, H., Li, J., Whittenbarger, D. J., & Marmor, J. J. (2010). The effects of daily facial lotion containing vitamins B3 and E and provitamin B5 on the facial skin of Indian women: A randomized, double-blind trial. Indian J Dermatol Venereol Leprol, 76(1), 20-26. doi: 10.4103/0378-6323.58674 

Lévesque, M., Feng, Y., Jones, R. A., & Martin, P. (2013). Inflammation drives wound hyperpigmentation in zebrafish by recruiting pigment cells to sites of tissue damage. Disease Models & Mechanisms, 6(2), 508–515. doi:10.1242/dmm.010371

Lynde, C. B, Kraft, J. N., & Lynde, C. W. (2006). Topical treatments for melasma and postinflammatory hyperpigmentation. Skin Therapy Letter, 11(9), 1-6. Retrieved from http://www.skintherapyletter.ca

Negrini, D., & Moriondo, A. (2011). Lymphatic anatomy and biomechanics. J Physiol, 589(12), 2927-2934. doi:10.1113/physiol.2011.206672 

Olczyk, P., Mencner, L., & Komosinska-Vassev, K. (2014). The role of the extracellular matrix components in cutaneous wound healing. Biomed Research International, 2014, 1- 8.  doi: 10.1155/2014/747584 

Pyke, C. (2010). Massage: A helping hand for the people with chronic oedema and lymphoedema. Br J Community Nurs, 15(4), S28-30. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/20559174

Rohl, J., Zaharia, A., Rudolph, M. & Murrary, R. Z. (2015). The role of inflammation in cutaneous repair. Wound Practice and Research, 23(1), 8-15.  Retrieved from http://www.awma.com.au

von der Weid, P.-Y.,& Zawieja, D. C. (2004). Lymphatic smooth muscle: The motor unit of lymph drainage. IJBCB, 36, 1147-1153.  doi:10.1061/j.biocel.2003.12.008

Williams, A. (2010). Manual lymphatic drainage: Exploring the history and evidence base. British Journal of Community Nursing, 15(4), S18-24. doi: 10.12968/bjcn.2010.15.Sup3.47365

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