Lymphedema is swelling caused by obstruction or reflux in the lymphatic vessels and is one of the most common conditions affecting humans. The lymph vessels are long, thin-walled tubes that form a very intricate network in the arms and the legs. In some cases, these lymph vessels are absent or are damaged or destroyed, and lymph fluid accumulates in the tissues of the arm or leg causing severe swelling. There are millions of cases in the United States, many of which have occurred following cancer, radiation therapy, trauma, infection, or other causes like obesity. It is estimated that there are more than 100 million people worldwide with lymphedema. In the developing world, infection (filariasis) is the most common cause of this condition.
Lymphedema is suggested by limb swelling that occurs spontaneously in infancy or during puberty; it can also develop after trauma, surgery, or infection. It is characterized by limb, ankle, and foot swelling associated with induration and sclerotic (scale-like) appearing skin. The skin typically develops “orange peel” rigidity and the foot and toes are often square or sausage shaped. There may be associated venous disease including chronic venous obstruction, venous incompetence, varicose veins, and other forms.
In its most severe form and when untreated, the foot and leg can be double or triple of the normal size, and patients may encounter a lot of difficulty finding shoes that will fit them. It is important to rule out underlying chronic venous disease to treat this condition.
In the initial stages of this disease, the swelling in the lower extremity is soft. However, as time progresses, the swelling becomes permanent and the limb becomes hard with a scalelike appearance of the skin.
We will talk about diagnosis and management of this disease next month.
BIO: Dr. Aparajita is a fellowship-trained vascular and endovascular surgeon. She is a co-author of 20-plus journal articles and publications and was recently nominated for an Inspiration Award by the American Medical Association.
This column is sponsored by KSC Cardiology, and the opinions expressed herein may not reflect those of CFHN or its advertisers.
