INTRODUCTION
Podoconiosis, or non-filarial elephantiasis, is characterized by progressive lymphedema that affects the lower extremities of individuals with long-term exposure to alkalic volcanic red clay soil.1 Affecting nearly 4 million individuals worldwide, it is known or suspected to be endemic in 32 countries across the globe, primarily in tropical regions within Africa, Asia, and Central America.2-4
revalence data from Ethiopia alone estimate that approximately 1 million individuals are affected by podoconiosis, resulting in an estimated $200 million in annual economic losses.5 Ethiopian patients incur an average annual cost of approximately USD 136, a substantial figure given the number of individuals living below the international poverty line ($1.9 USD per capita per day). Additionally, the absence of podoconiosis cases within the United States contributes to limited awareness among US dermatologists, hindering international public health efforts, research, and recognition in recent immigrant populations.
While the pathogenesis of podoconiosis has not been entirely elucidated, it is thought to arise from cumulative barefoot exposure to mineral particles found in red clay soil, triggering inflammation in genetically susceptible individuals and leading to progressive lower extremity swelling.1,6 Without treatment, it severely impacts quality of life, daily activities, and social integration due to surrounding stigma.
Currently, no definitive diagnostic test for podoconiosis exists, leading to misdiagnosis, delayed treatment, and advanced lymphedema with fewer existing therapies.2 In low-income countries, advanced lymphedema and limited therapies exacerbate the challenges of podoconiosis, including economic insecurity, reduced work capacity, psychological stress, and social stigma.7 This review aims to highlight the global health burden of podoconiosis and advocate for improved education, diagnostics, and treatment strategies.
revalence data from Ethiopia alone estimate that approximately 1 million individuals are affected by podoconiosis, resulting in an estimated $200 million in annual economic losses.5 Ethiopian patients incur an average annual cost of approximately USD 136, a substantial figure given the number of individuals living below the international poverty line ($1.9 USD per capita per day). Additionally, the absence of podoconiosis cases within the United States contributes to limited awareness among US dermatologists, hindering international public health efforts, research, and recognition in recent immigrant populations.
While the pathogenesis of podoconiosis has not been entirely elucidated, it is thought to arise from cumulative barefoot exposure to mineral particles found in red clay soil, triggering inflammation in genetically susceptible individuals and leading to progressive lower extremity swelling.1,6 Without treatment, it severely impacts quality of life, daily activities, and social integration due to surrounding stigma.
Currently, no definitive diagnostic test for podoconiosis exists, leading to misdiagnosis, delayed treatment, and advanced lymphedema with fewer existing therapies.2 In low-income countries, advanced lymphedema and limited therapies exacerbate the challenges of podoconiosis, including economic insecurity, reduced work capacity, psychological stress, and social stigma.7 This review aims to highlight the global health burden of podoconiosis and advocate for improved education, diagnostics, and treatment strategies.
MATERIALS AND METHODS
A narrative review was conducted using PubMed, OvidMedline, and the Cochrane Library with search terms including "podoconiosis," "non-filarial elephantiasis," and "endemic elephantiasis." Non-English, duplicate, and irrelevant studies were excluded. Titles and abstracts were screened for focus on podoconiosis epidemiology, etiology, diagnosis, treatment, prevention, and public health burden. Studies referencing elephantiasis, lymphedema, and other tropical diseases outside the scope of this review were excluded, as well as articles focusing on concurrent diagnoses or co-infection.
Historical Aspects
Dr. Eric J. T. Price, a British medical missionary, first documented podoconiosis in the 19th century, coining "mossy foot" to describe cases in Ethiopia and Cameroon.3,8-10 His findings highlighted a characteristic asymmetric swelling of the lower
Historical Aspects
Dr. Eric J. T. Price, a British medical missionary, first documented podoconiosis in the 19th century, coining "mossy foot" to describe cases in Ethiopia and Cameroon.3,8-10 His findings highlighted a characteristic asymmetric swelling of the lower
