Dèmes

Dèmes, the plural form of the French term dème, correspond to the medical condition known in English as edema. They refer to the abnormal accumulation of excess fluid in interstitial spaces or body cavities. Edema results from an imbalance between capillary filtration and reabsorption, impaired lymphatic drainage, or increased capillary permeability, and it often affects dependent areas such as the legs, ankles, and feet. Dèmes can be localized or generalized (anasarca).

Common forms include pitting edema, where an indentation remains after pressing the skin, and non-pitting edema, which may be seen in lymphedema or inflammatory states. Dependent edema arises from gravity in upright individuals. Lymphedema results from lymphatic obstruction or congenital absence of lymphatics and may require specialized assessment.

Causes are diverse and include heart failure, nephrotic syndrome, liver cirrhosis, venous insufficiency, and pregnancy. Medications such as calcium channel blockers and NSAIDs can contribute, as can infections or localized trauma. The clinical presentation and distribution help guide investigation and management.

Diagnosis relies on history and examination, supported by laboratory tests and targeted imaging. Investigations may include kidney and liver function tests, albumin level, urinalysis, and imaging such as ultrasound to exclude deep-vein thrombosis, echocardiography for heart failure, or chest imaging for pulmonary edema. Evaluation for lymphedema may involve specialized imaging in selected cases.

Management targets the underlying cause and symptom relief. Measures include limb elevation and, where appropriate, compression therapy. Diuretics may be used for systemic causes, with dietary sodium restriction and weight management recommended as adjuncts. Severe or refractory dèmes, or those suggestive of lymphedema, should be managed by a specialist.