What Is Lymphedema?
It is a chronic disease caused by a defect in the lymphatic system that involves a build up of lymph in the interstitial space (cell space), which at first is mainly located above the fascial layer (tissue above the muscle fascia) and afterwards all The subcutaneous tissue.
What are the main causes of the disease?
There have been numerous classifications proposed to frame lymphedema. There are sporadic shapes from the familiar ones, which can mostly be classified into more or less complex malformative syndromes, whether or not related to specific genetic alterations. In hereditary-family forms (primary), the defect is often due to dysplasia of the lymph vessels. In the term dysplasia include: agenesis (lack of formation), hypoplasia (incomplete formation), hyperplasia (excessive formation), fibrosis, lymphangiomatosis (larger lymphatic vessels and larger than normal), amartomatosis (benign tumor formation), valve failure.
Secondary lymphedema can be distinguished in post-surgical, post-attinic (post-radiotherapy), post-traumatic, post-lymphangitis and parasitic diseases. In secondary lymphedema, especially for post-traumatic, post-lymphangitis, but also for surgery and / or radiotherapy, there is almost always a constitutional predisposition (lymphatic and / or congenital lymph node dysplasia).
Are there protective factors?
An active lifestyle, a balanced diet, proper hydration, and regular physical activity are correlated with a lower incidence of the disease.
How does it affect the disease?
Primary lymphedema is a sudden and unexpected clinical condition. Contrary to the secondary one, which is clinically conceivable even if it is not possible to predict the time of onset. This disease causes a build up of lymph and fluid (edema) at the level of the limbs. In the most advanced stages, edema tends to consolidate, becoming more and more severe, resulting in skin thickening (pachydermia) and loss of elasticity. If neglected, lymphedema can result in the onset of trophic lesions (ulcers) and / or actual deformity of the limbs (elephantiasis).
What are the signs and what are the symptoms?
The disease occurs with tissue edema (usually swelling), usually located in the limbs, presence of the Stemmer sign (not the skin’s applicability at the base of the 2nd finger of the foot), skin dystrophic lesions (post-lymphocytic sequences, hyperkeratosis, verrucosis Lymphostatic, linforrea, chilorrea, etc.), frequent dermatolymphoid-adenitis complications.
What are the instrumental examinations needed for proper diagnosis?
EcocolorDoppler is the first choice for the diagnostic definition of the edema, to confirm the lymphatic nature, to identify the cause (obstruction or reflux), to evaluate the extent of the disease, the major impairment or Lower in the lymphatic circulation than the superficial, drainage through the lymph nodes.The second diagnostic level is CT, RM and lymphography; The third level, from phlebography, arteriography, genetic analysis, biopsy.
What treatments are available today?
- Regular physical activity.
- Pharmacological Therapy (drugs that can improve lymphatic microcirculation, diuretics and lymphotrops).
- Elastomeric bandage.
- Vascular biophysical therapy.