A 16-year-old female teenager reported that she began to present with edema of her right leg at the age of three at which time she sought treatment; however, the cause of the swelling was not diagnosed. At ten years of age, she also observed that her left leg was swollen, and at the age of 13, a lymphoscintigraphy was performed which detected lymphedema of all four limbs, arms, and legs. At 16 years of age, after erysipelas, the edema of the lower limbs worsened and clinically identifiable lymphedema of the right arm was observed, especially the hands, so she sought the Clinica Godoy for treatment. A volumetric evaluation was performed of all four limbs, and an intensive 8-hour treatment program was proposed. The adolescent was submitted to manual (Godoy & Godoy technique) and mechanical lymphatic therapy (RA Godoy) of the lower limbs, cervical lymphatic therapy (cervical stimulation), and the continuous use of a grosgrain stocking.
A reduction in the size of all four limbs was observed at the end of the 5-day treatment program without using any therapies specifically to treat the arms (Table 1). Maintenance of the results also used the grosgrain stocking and mechanical lymphatic therapy (RA Godoy) of the legs at the patient's home.
In the maintenance phase, the patient was advised about the need of skin care. Moreover, she performed myolymphokinetic exercises of both the legs and arms, prioritizing activities that require little effort and did not involve impact or repetitive movements that could aggravate the edema. The patient was asked to return for monitoring by the care team every three months; however, she did not return. Only after four years, she returned to the service to treat an outbreak of erysipelas of the legs and the accompanying worsening of the lower limb lymphedema. At this time, she did not present with edema of the arms (Table 2). Thus, the initial intensive treatment for leg lymphedema was sufficient to treat the arm lymphedema.
This case report was approved by the Research Ethics Committee of FAMERP (# CAAE: 27810214.6.0000.5415).