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Lymphedema

Lymphedema

The lymphatic system is a transportation system, which exists in addition to the vascular system and extends in close proximity thereof. The venous system and the lymphatic system are both for the transportation of substance, some substances are only carried by the lymphatic system (lymphatic substances).

Damage to the lymphatic system causes proteins and tissue fluid to stay in the tissues - and remain between the cells. As a result tissue swelling occurs, which is referred to as lymphedema. The most common form of lymphedema caused by lymphatic substances congested in tissue is the swelling of the arms and legs.

There are two different origins of lymphoedema:

The lymphatic system may be genetically weak. Once the lymphatic system can no longer transport lymphatic substances efficiently, a primary lymphedema develops sooner or later. "Primary" because the cause is the structure of the lymphatic system itself.

The lymphatic system is genetically efficient; but an external influence (eg, injury, surgery) disturbs its functionality. This may eventually lead to a limited function of the lymphatic system and a secondary lymphedema may develop . "Secondary" because the cause is an external factor.

A Lymphedema does not develop overnight, because the body has several mechanisms to compensate. Once the development process is triggered a complicated mechanism is set in motion which makes the lymphedema progress over time. Due to the gradual development of lymphedema physicians have classified four different clinical stages of lymphedema, in which different symptoms may occur:

Stage 0 (latent stage): This is the situation described above, the lymphatic system is already working inadequately, but the body compensates with other mechanisms. There is no edema present.

Stage I (reversible stage): The lymphatic system is overwhelmed; there is a protein-rich swelling in the affected area, but the tissue is still soft. One can push dents into the skin by pressing it. By elevating the affected arm or leg the swelling goes away by itself.

Stage II (spontaneous irreversible stage): The swelling is already characterized by the occurrence of excess connective tissue; fibrosis and sclerosis are formed. It is no longer possible to push dents on the skin; elevating the affected arm or leg no longer leads to a decrease in the swelling.

 

Stage III (elephantiasis): Tissue becomes extremely swollen and increasingly fibrotic (hardened). Pressure does not produce any pitting. Normal elasticity is lost and the skin hangs in folds.The skin may change color.

  • Papillomas - small solid benign tumors that project above the surrounding tissue - may develop.
  • Hyperkeratosis - an increase in the thickness of the outer layer of the skin - may develop.

These changes in the texture of the skin are disfiguring and can limit mobility.

Infections become more common because of increased risks of breaks in the skin. These infections include fungal infections and open wounds that form within the folds of skin. The sooner an appropriate therapy is started, the better are the chances of preventing the progression and even improving the condition, that is, to diminish severity of the edema.

Due to the various types of venous diseases and lymphatic diseases please consult a physician for proper diagnosis and treatment.