Lymphedem

Lymphedem, a term sometimes used to describe lymphedema, is a chronic condition defined by swelling caused by impaired or obstructed lymphatic drainage. The spelling Lymphedem is not standard in most medical references, where the accepted term is lymphedema.

Causes and types: Primary lymphedema results from congenital abnormalities of the lymphatic system. Secondary lymphedema arises from damage to or removal of lymph nodes or vessels, often after cancer surgery, radiation therapy, infection (such as lymphatic filariasis), or trauma. Risk factors include obesity and older age.

Symptoms and diagnosis: The main sign is swelling, usually in one limb, often accompanied by heaviness, stiffness, limited movement, and recurrent skin infections. Diagnosis combines clinical assessment with measurements of limb size and imaging to assess lymphatic function. Imaging options include lymphoscintigraphy and near-infrared fluorescence imaging; ultrasound or MRI may help exclude other conditions.

Treatment and management: There is no cure, but swelling and symptoms can be managed. The standard approach is complete decongestive therapy, including manual lymph drainage, compression garments, exercise, and careful skin care to prevent infections. In some cases, surgical options such as lymphatic bypass, vascularized lymph node transfer, or liposuction for advanced edema may be considered. Diuretics are not routinely used for lymphedema.

Prognosis and prevention: With ongoing management, swelling can be controlled and function improved, though fluctuations are common. Preventive measures include treating infections promptly and minimizing lymphatic damage after surgery or radiotherapy. Epidemiology: lymphedema affects millions worldwide, with secondary lymphedema after cancer treatment prominent in high-resource settings and filarial lymphedema a major burden in endemic regions.