All About Lymphedema
What is Lymphedema?
Lymphedema is a progressive chronic swelling of the limbs or genitalia from lymphatic system insufficiency. It is characterized by the accumulation of protein-rich interstitial fluid or lymph fluid.
Pathophysiology of lymphedema
Lymphedema is caused by a reduction in lymphatic transport resulting from increased demand for lymphatic flow or decreased capacity of the lymphatic circulation. Lymph nodes act like a drain in your sink. If the drain is clogged, the fluid cannot drain. It usually happens in the arms or legs but can occur in other parts of the body. Lymph fluid is part of the lymph system that carries fluid and cells that help fight infections throughout the body. Sometimes this swelling develops quickly, or it may develop slowly over several months. There are several anatomic deficiencies that lead to lymphedema, including lymphatic hypoplasia and functional insufficiency of lymphatic valves.
Classification of lymphedema
The simplest classification of lymphedema relies upon differentiation between primary and secondary causes. Primary lymphedema is often classified according to the age at which the edema first appeared. Congenital lymphedema is apparent at birth or becomes recognized within the first 2 years of life. Lymphedema praecox is most commonly detected at the time of puberty but may appear as late as the third decade of life. Lymphedema tarda typically appears after age 35 years.
What Causes Lymphedema?
Lymphedema can be caused by cancer or by cancer treatment.
Sometimes a cancerous tumor can get big enough to block the lymph system.
Surgery to remove acancer may also remove lymph nodes or some of the vessels that carry the lymph fluid. This can cause the fluid to build up in surrounding tissues.
Radiation treatment can damage the lymph vessels, resulting in too much lymph fluid in the tissues.
What Causes Lymphedema?
Lymphedema can be caused by cancer or by cancer treatment.
Sometimes a cancerous tumor can get big enough to block the lymph system.
Surgery to remove acancer may also remove lymph nodes or some of the vessels that carry the lymph fluid. This can cause the fluid to build up in surrounding tissues.
Radiation treatment can damage the lymph vessels, resulting in too much lymph fluid in the tissues.
I Think I Have Lymphedema. What Should I Do?
It is very important to see a doctor right away to find out why you have swelling. You should make sure there is no other cause of the swelling that needs immediate treatment, like a blood clot.
Diagnosis of lymphedema
In most patients with advanced lymphedema, the characteristic clinical presentation and physical findings establish the diagnosis with near certainty (41). However, early in the natural history, or with presentations of mild or intermittent swelling, it may be more difficult to distinguish lymphedema from other edematous states. Several physical features distinguish lymphedema from other causes of chronic edema of the extremities. Among these are the classic changes of cutaneous and
Chronic venous insufficiency and postphlebitic syndrome
This common condition is often confused with lymphedema of the legs. Its distinguishing clinical features include aching discomfort in the lower extremities during sitting or standing and chronic pruritus, particularly overlying the incompetent communicating veins (56). Physical findings include cutaneous deposits of hemosiderin, dusky discoloration and venous engorgement with dependence, cutaneous varicosities, and if advanced, ulceration of the skin
Myxedema
General therapeutic measures
Lymphedema is a chronic condition that requires lifelong attention. Meticulous attention to control of edema may reduce the likelihood of disease progression and limit the incidence of soft-tissue infections (41). Aggressive implementation of decongestive lymphatic therapy is the mainstay of most therapeutic recommendations 61, 62, 63. This complex form of physical therapy integrates meticulous skin care, massage, exercise, and use of compressive elastic garments. Decongestive lymphatic therapy