cardiovascular disorders
Lymphedema
Symptoms and Signs of Lymphedema
Symptoms of lymphedema include aching discomfort and a sensation of heaviness or fullness. The cardinal sign is soft-tissue edema, graded in 3 stages: Stage 1: The edema is pitting, and the affected area often returns to normal by morning. Stage 2: The edema is nonpitting, and chronic soft-tissue inflammation causes early fibrosis. Stage 3: The edema is brawny and irreversible, largely because of soft-tissue fibrosis. The swelling is most often unilateral and may worsen when the weather is warm, before menstruation occurs, and after the limb remains for a long time in a dependent position. It can affect any part of the limb (isolated proximal or distal) or the entire extremity; it can restrict range of motion when swelling is periarticular. Disability and emotional distress can be significant, especially when lymphedema results from medical or surgical treatment. Skin changes are common and include hyperkeratosis, hyperpigmentation, verrucae, papillomas, and fungal infections. Rarely, an affected limb becomes extremely large, and the hyperkeratosis is severe, giving the appearance of elephant skin (elephantiasis). This manifestation is more common with filariasis than with other causes of lymphedema. Lymphangitis None Rarely, long-standing lymphedema leads tolymphangiosarcoma(Stewart-Treves syndrome), usually in postmastectomy patients and in patients with filariasis. 