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Still later, hyperpigmentation and hyperkeratosis
develop, often with wartlike protuberances which, on histological section, reveal dilated
loops of lymphatic vessels within the nodular lesions. Patients with chronic
lymphedema or elephantiasis rarely are microfilaremic. Redundant skin folds, of the skin
provide havens for bacteria and fungi to thrive and intermittently penetrate the epidermis
to lead to either local or systemic infections. Sometimes the skin over the breaks down,
causing the dilated lymphatic within to rupture and discharge its lymph fluid directly
into the environment, at the same time serving as a causeway for penetration of bacterial
or fungal organisms directly into the lymphatic system. Chyluria, another of the chronic filarial syndromes, is caused by
the intermittent discharge of intestinal lymph (chyle) into the renal pelvis and
subsequently into the . The clinical course is intermittent, sometimes remitting. |