The medical history (history of the patient) represents an important component in the diagnosis of lymphedema. Family history Is there a frequent occurrence of lymphatic system disease in your family? Social anamnesis Current medical history/systemic history (somatic and psychological complaints). When did you notice the circumferential increase? Where is the circumferential increase localized? In more … Lymphedema: Medical History
Endocrine, nutritional, and metabolic diseases (E00-E90). Obesity (obesity). Cardiovascular system (I00-I99) Podoconiosis (Greek. πούς, genitive ποδός “foot” and κονία, konia “dust”; synonyms: endemic non-filarial elephantiasis, “mossy foot” disease, elephant foot disease, or Price’s disease (“Price’s disease”)) – noninfectious type of elephantiasis; microparticles found in soils with a high content of red laterites of volcanic origin … Lymphedema: Or something else? Differential Diagnosis
The following are the most important diseases or complications that may be contributed to by lymphedema: Skin and subcutaneous (L00-L99). Skin changes in the area of the edema Lymphatic ulcer (ulcer) with the risk of malignant (malignant) degeneration. Hardening of the edema Cardiovascular system (I00-I99) Elephantiasis – irreversible thickening/hardening of the skin with massive fluid … Lymphedema: Complications
A comprehensive clinical examination is the basis for selecting further diagnostic steps: General physical examination – including blood pressure, pulse, body weight, height; furthermore: Inspection (viewing). Skin and mucous membranes [Leading symptoms: Frequently dry, itchy skin Positive Kaposi-Stemmer sign (clinical sign of the presence of lymphedema) – it is positive in the absence of lift-off … Lymphedema: Examination
The diagnosis of lymphedema is made clinically by means of basic diagnostics (history, inspection, and palpation). Second-order laboratory parameters-depending on the results of the history, physical examination, and obligatory laboratory parameters-are used for differential diagnostic clarification Small blood count Inflammatory parameters – CRP (C-reactive protein). Analysis of lymphatic fluid – for diagnosis of lymphatic malformations. … Lymphedema: Test and Diagnosis
Drug therapy for lymphedema is not available. See also under “Further therapy.”
The diagnosis of lymphedema is made clinically using basic diagnostics (history, inspection, and palpation). Optional medical device diagnostics-depending on the results of the history, physical examination, and obligatory laboratory parameters-are used for differential diagnosis. Sonography (ultrasound examination) of the affected body region – to assess tissue changes. Isotope lymphography – shows the functional status of … Lymphedema: Diagnostic Tests
Conservative therapy should have been given for at least six months before surgical therapy. The following surgical procedures may be considered: Reconstructive microsurgical procedures Microsurgical autogenous lymphatic vessel transplantation. Interposition (interposition) of autogenous veins. Deviating procedures Lymphovenous/lymphonodulovenous anastomoses. Resection procedure Liposuction (liposuction) Tissue resection with direct wound closure, plastics or split skin grafting.
The following symptoms and complaints may indicate lymphedema: Leading symptoms Doughy swelling of the skin/subcutaneous tissue (doughy edema). Positive Kaposi-Stemmer sign (clinical sign of the presence of lymphedema) – it is positive in the absence of lift-off of the interdigital skin on the forefeet (a negative Kaposi-Stemmer sign does not rule out lymphedema) Frequent dry, … Lymphedema: Symptoms, Complaints, Signs
Pathogenesis (development of disease) In lymphedema, damage to the lymphatic system, which may be congenital or acquired, results in an increase in interstitial (from Latin interstitium = “interstitial space”) tissue fluid. As the disease progresses, tissue senescence (tissue alteration) occurs, with an increase in connective and adipose tissue, as well as changes in the extracellular … Lymphedema: Causes
General measures Aim for normal weight! Determination of BMI (body mass index, body mass index) or body composition by means of electrical impedance analysis and, if necessary, participation in a medically supervised weight loss program or program for underweight. Regular check-ups Regular medical checkups Nutritional medicine Nutritional counseling based on nutritional analysis Nutritional recommendations according … Lymphedema: Therapy
Stages of lymphedema Stage Description 0 No swelling, pathological lymph scintigraphy I Edema of soft consistency (protein-rich edema; a “dent” can still be easily made with a finger), can be influenced by elevation II Edema with secondary tissue changes (no dent or only a shallow dent can be made in the skin with the finger), … Lymphedema: Classification
