nonpitting

Nonpitting edema is a form of tissue swelling in which pressing on the swollen area does not leave a lasting indentation. Unlike pitting edema, where a finger press into the tissue leaves a visible pit that persists for a time, nonpitting swelling often feels firmer and may be accompanied by thickened or hardened skin.

Common causes include lymphatic obstruction (lymphedema), which can be primary (congenital) or secondary (due to surgery, infection, cancer, or scar formation); hypothyroidism, where mucopolysaccharide deposits in the skin create a nonpitting, doughy swelling known as myxedema; and inflammatory or infectious conditions that lead to tissue infiltration and edema. Nonpitting edema can also occur with certain medications or in localized areas where tissue fibrosis has developed.

Diagnosis relies on clinical examination and history. The clinician confirms nonpitting character by repeatedly pressing with a finger. Evaluation may include measurement of limb circumference, imaging studies to assess venous and lymphatic systems, thyroid function tests, and screening for infection or inflammatory diseases. Distinguishing nonpitting from pitting edema helps guide management and the search for underlying causes.

Treatment centers on addressing the underlying condition and reducing swelling. For lymphedema, management typically includes compression therapy, manual lymph drainage, exercise, and meticulous skin care. Hypothyroidism is treated with thyroid hormone replacement. Inflammatory or infectious causes require appropriate anti-inflammatory or antimicrobial therapy. Diuretics are generally not effective for nonpitting edema due to lymphedema and are not the primary treatment unless there is a concurrent fluid overload. Ongoing monitoring and lifestyle adjustments are often necessary to control symptoms.