Lymphedema is a condition where edema is caused by dysfunctional lymphatic system, which can be caused by inherent lymphatic structure deficits or lymphatic destruction. Long term lymphedema leads to interstitial fibrosis, in which non-pitting, brawny tissue accumulates in the extremity due to chronic inflammation.
Primary Lymphedema
- Congenital lymphedema – symptoms onset within first 1 year of age
- Lymphedema praecox – 1 to 35 years
- Lymphedema tarda – 35 and older
- Familial primary lymphedema is called Milroy’s diseas
Secondary Lymphedema
- Secondary lymphedema is caused by injury, surgery, or obstruction by cancer or infection.
- It is the most common type of lymphedema in the U.S., owing to large number of surgical lymphadenectomy and/or radiation therapy for various cancers.
Treatment of Lymphedmea
Lymphedema is unfortunately very difficult to treat, especially in severe cases. Mainstay of therapy includes:
- Elevation and compression
- Skin care and hygiene to avoid infections
- Physical therapy including manual massage or other decongestive therapies
- Surgical techniques include debulking tissues, lymphovenous reconstruction, and lymphatic grafting. Their success rates vary and are usually reserved for severe cases at specialized centers.
Lipedema can be differentiated from lymphedema as lipedema has pain with skin palpation and spares the foot and toes.