Doctor's Notes on Lymphedema
Lymphedema is defined as swelling in one or more of the arms or legs due to damage or inadequate function of the lymphatic system to move lymph fluid. Signs and symptoms include
- swelling of one or more extremities that can range from mild to severe.
- The skin is firm and does not pit when the skin is compressed by a finger.
- The skin may become scaly, cracked and may resemble an orange peel; the skin can become tender and sore.
Severe lymphedema can be disfiguring and limit limb mobility.
There are two general causes of lymphedema, primary (due to an intrinsic defect in the lymph system) and secondary (due to damage or destruction of an otherwise normal lymph system).
- Primary causes are uncommon and are genetically caused like congenital lymphedema or Milroy disease (genetic, sex-linked).
- Secondary causes are common and are caused by surgeries like breast cancer surgery, infections like filariasis, trauma, cancer cells that block lymphatics, burns, scars and radiation exposure.
What are the treatments for lymphedema?
Although there is no cure, lymphedema treatments are designed to prevent the complication of cellulitis and reduce areas of swelling. Preventive antibiotics can be prescribed and used if the swollen tissues begin to develop cellulitis (redness, warmth of swollen skin, for example). Two other general treatments are also used to reduce edema:
- Compression therapy
- Exercises to use muscles to move edema fluid
- Manual lymph drainage – massage-like therapy
- Compression bandages and/or garments – gently squeeze lymphedema out of affected limb
- Pneumatic compression – sleeve over affected limb that pumps pressure into sleeve and then releases it, providing a mechanical squeeze to move fluid
- Surgical therapy
- Lymph node transplant – lymph nodes not affected in the patient attached to affected nodes to improve lymph flow
- New drainage routes – surgical made connections between lymph nodes and blood vessels
- Surgical removal of obstructive fibrous tissue blockage
Your doctors can design a treatment protocol for your individual problems with lymphedema.
Breast Cancer : Symptoms & Signs QuizQuestion
A lump in the breast is almost always cancer.See Answer
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Kasper, D.L., et al., eds. Harrison's Principles of Internal Medicine, 19th Ed. United States: McGraw-Hill Education, 2015.