Lymphoedema

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Lymphoedema is limb swelling resulting from failure of the lymphatic system to transport fluids via lymphatic vessels and lymph nodes.

What is Lymphoedema?

The affected limb becomes progressively more swollen, heavy and uncomfortable.  As the swelling worsens, skin complications of ulceration, hyperkeratosis and fissuring develop.  The limb is prone to recurrent attacks of cellulites which exacerbates the swelling further.

 

The results of surgical attempts to correct lymphatic obstruction are poor.  Treatment is supportive in the form of compression stockings and skin care.  Attacks of cellulitis require prolonged antibiotic therapy (eg penicillin V 500mg qds for one month) and elevation during the acute early stage of the infection.

 

The causes of lymphoedema are shown below:

 

 Primary lymphoedema Congenital (symptoms appear as an infant)

Familial (Milroy's disease)

Non-familial

  Praecox (adolescence) Familial and non-familial types
  Tarda (over 35 years) Often associated with obesity
 Secondary Infection (commonest cause worldwide but not in the West) Filariasis (causes elephantitis)
  Cancer Malignant obstruction of lymph nodes for metastases
  Surgery/Radiotherapy Especially to axilla for treatment of breast cancer

What part of the body does it affect?

Lymphoedema can affect the limbs, predominantly the legs. 

What are the symptoms?

The affected limb becomes progressively more swollen, heavy and uncomfortable. The limb is prone to soft tissue infections called cellulitis.

Is the condition preventable? If so, how?

Patients will have a genetic predisposition towards having lymphodoema but it is also exacerbated by obesity. It can also be caused by some tropical worm infections so avoid wading or swimming in water in high risk areas. 

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