Primary lymphedema (rare): idiopathic, resulting from congenital abnormalities in lymphatic vessels, e.g., in Turner syndrome
Secondary lymphedema: physical disruption of lymphatic drainage
Lymphadenectomy, radiation
Malignant obstruction
Chronic inflammation (eg, recurrent cellulitis)
Parasitic infection (eg, filariasis)
Pathophysiology
Painless unilateral or bilateral swelling of limbs
In early disease, the edema is pitting and the skin remains soft. However, over time there is progressive deposition of subcutaneous collagen and adipose tissue, which leads to firm, dry, and thickened skin and nonpitting edema
Swelling of toes and dorsal feet with deep flexion creases
Lymphedema involves the toes, unlike venous edema, which typically spares the toes.
Clinical features
Diagnostics
Treatment
Manual lymphatic drainage: a form of massage that is applied in the direction of the heart to increase the natural drainage of lymph
Compression garments, e.g., multilayer compression stockings (applied by a specialist)
Should be applied by a trained professional (e.g., a physiotherapist or clinical lymphologist) as they can be harmful or ineffective when applied incorrectly.