Podoconiosis is a rare disorder in which the feet and lower legs swell tremendously, often leading to their hardening and disfigurement. Podoconiosis occurs in people who are genetically susceptible and walk barefoot in volcanic red-clay soil. These people develop an inflammatory reaction in their feet after repeated, long-term exposure to irritating minerals – like aluminium and silicon – in the soil. These irritating particles leak into the body causing oedema (swelling), alongside the other symptoms of podoconiosis. The people most frequently affected by podoconiosis are low-income farmers in East Africa, India, and Central America.
Podoconiosis leads to elephantiasis, which is a large group of symptoms and disorders, named for how they make the limbs resemble that of an elephant. Symptoms of podoconiosis include:
These symptoms can occur in most forms of elephantiasis, and it’s important to have a doctor determine exactly what type of elephantiasis is occurring. Some forms are caused by an infection – known as Filarial Elephantiasis – and some – like podoconiosis (aka Non-Filarial Elephantiasis) – are not.
Also, people with podoconiosis often face a lot of social stigma and ostracization. This can lead to depression and poor mental health, which are symptoms that are also extremely important to discuss with a doctor.
Podoconiosis is caused by chemical irritants in red-clay soil that cause inflammation, swelling and skin changes in the legs and feet. In people who are genetically susceptible to it, podoconiosis can occur if they are continuously barefoot in the soil. Chemical irritants can penetrate bare feet, and go from there into lymphatic vessels, which are vessels that normally move drain excess fluid from the body. The irritants cause the lymphatic vessels to malfunction, no longer draining correctly, and leading to elephantiasis symptoms.
Podoconiosis has several risk factors, including:
Podoconiosis is diagnosed clinically, by a doctor’s assessment. The doctor will typically exclude other causes of elephantiasis, especially infectious causes, by taking blood samples.
The first-line treatment of podoconiosis is the same as prevention – wearing shoes and proper foot hygiene. In the regions where podoconiosis is most prevalent, some governments have banned walking barefoot when outdoors.
Further management of podoconiosis can involve elevation of the feet at night, applying special creams to the legs, and the use of compression socks or bandages. Sometimes, if podoconiosis is very severe or if there is a particularly hard region (called a nodule) on the leg or foot, it may require surgery for removal.