| Lymphedema | |
|---|---|
| Other names | Lymphoedema, lymphatic edema, lymphatic obstruction, lymphatic insufficiency |
 | |
| Lower extremity lymphedema | |
| Specialty | Vascular medicine, physical medicine and rehabilitation, plastic surgery |
| Symptoms | Swelling, discomfort, heaviness, joint stiffness, skin thickening[1][2] |
| Complications | Infection, deep vein thrombosis, lymphangiosarcoma[2] |
| Types | Stage 0 to 3[1] |
| Causes | Cancer, parasitic infections, genetic disorders[2] |
| Risk factors | Obesity[3] |
| Diagnostic method | Based on symptoms[1] |
| Differential diagnosis | Lipodystrophy, venous insufficiency, heart failure, kidney problems, cirrhosis[1][2] |
| Treatment | Compression therapy, good skin care, exercise, manual lymphatic drainage[1][3] |
| Frequency | ~200 million[4] |
Lymphedema is localized swelling due to a compromised lymphatic system.[1] Other symptoms may include discomfort, heaviness, joint stiffness, and skin thickening.[1][2] Complications may include infection, deep vein thrombosis, and lymphangiosarcoma.[2]
It most frequently occurs due to cancer and its treatment or parasitic infections (lymphatic filariasis), but may also be seen in a number of genetic disorders.[2] Risk factors include obesity.[3] The underlying mechanism involves a cycle of inflammation and fibrosis.[4] Diagnosis is generally based on symptoms, after other potential causes are ruled out.[1]
While there is no cure, treatment may improve outcomes.[1] This commonly include compression therapy, good skin care, exercise, and manual lymphatic drainage (MLD), known together as combined decongestive therapy.[1] Exercise may also be useful.[3] Diuretics are not useful.[1] Surgery is generally only used in those who are not improved with other measures.[1]
Lymphedema affects approximately 200 million people worldwide.[4] Women are more commonly affected than men.[4] About 1 in 5 women who survive breast cancer and 40% of women with gynecologic cancer develop lymphedema.[2] Genetic causes are much less common, occurring in about 1 in 100,000 people.[2] The condition has been described throughout ancient history.[5]
References edit
- ^ a b c d e f g h i j k l Grada AA, Phillips TJ (December 2017). "Lymphedema: Diagnostic workup and management". Journal of the American Academy of Dermatology. 77 (6): 995–1006. doi:10.1016/j.jaad.2017.03.021. PMID 29132859.
- ^ a b c d e f g h i Sleigh, BC; Manna, B (July 2020). "Lymphedema". PMID 30725924.
{{cite journal}}: Cite journal requires|journal=(help) - ^ a b c d "Lymphedema (PDQ®)–Health Professional Version - National Cancer Institute". www.cancer.gov. 30 June 2008. Retrieved 20 February 2021.
- ^ a b c d Grada AA, Phillips TJ (December 2017). "Lymphedema: Pathophysiology and clinical manifestations". Journal of the American Academy of Dermatology. 77 (6): 1009–1020. doi:10.1016/j.jaad.2017.03.022. PMID 29132848.
- ^ Tyring, Steven K.; Lupi, Omar; Hengge, Ulrich R. (2016). Tropical Dermatology E-Book. Elsevier Health Sciences. p. 57. ISBN 978-0-323-33914-8.