If lymphoedema is left untreated and the swelling gets worse, skin changes may occur. The skin may get very thick with folds and bulges and cannot be lifted up or pinched. Dry warty spots appear on the ankles, feet and toes (elephantiasis nostras verruciformis, or lymphatic papillomatosis).
Lymphedema that is not controlled may cause:
more swelling, weakness, and difficulty moving your arm or leg. itchy, red, warm skin, and sometimes a rash. wounds that don't heal, and an increased risk of skin infections that may cause pain, redness, and swelling. thickening or hardening of the skin.
Stage III lymphedema is a severe and prolonged collection of edema or swelling in the body part. The skin can become hardened with a leathery feel. The color of the skin can become darker with a brownish tint. There may also be papillomas of the skin, which are small bumps that form on the skin and may leak fluid.
Stage 3: Severe stage
The tissue is fibrotic (hard) and pitting is no more possible. Skin changes, such as thickening, hyperpigmentation (change of color), increased skin folds, fat deposits, and wart-like growths, can develop. The skin becomes susceptible to deep, poorly healing wounds and is in danger of infection.
When lymphedema continues for an extended period of time with insufficient treatment, the symptoms can become more severe, and chronic changes to the skin around the affected area may become noticeable. Symptoms of chronic lymphedema may include: Skin discoloration and reddening.
The skin cannot contain all this lymph fluid, resulting in lobules, or huge globs of skin. The skin cells die, they turn black, and to touch the skin, it feels like you are touching the bark of a tree. People with Stage Three lymphedema have wounds and lymph leakage.
People with stage 2 lymphedema have visible swelling with pitting and a higher risk of infection. Elevating the affected area does not help. This means there is inflammation, hardening, or thickening of the tissue under the skin. As scarring of soft tissue under the skin worsens, pitting may disappear.
Stage 4: Elephantiasis (large deformed limb), skin thickening with “wart-like” growth and extensive scarring.
Axillary or inguinal lymph node injury is the most significant risk factor for developing lymphedema. Trauma to the lymphatic vasculature must be severe to cause lymphedema.
The protein-rich interstitial fluid of lymphedema leads to inflammation and an accumulation of fibroblasts, adiposities, and keratinocytes that transform the initially soft swollen tissue into a hard fibrotic tissue with stiff, thickened skin [1].
Avoid trauma or injury to the affected area. Avoid heavy lifting with the affected arm. No new tattoos in the affected area. Do not wear tight clothing, bands, shoes, or jewelry on the affected area.
Some foods can exacerbate lymphedema symptoms because of the way they are processed and the additives or high salt content they contain. These foods include added sugars — specifically fructose — refined grains, chemically modified fats and most animal and dairy products.
Lymphedema can't be cured, but you can control the swelling and keep it from getting worse. Getting to and staying at a healthy weight may make it better, but "water pills" usually won't. Specialized lymphedema therapists can also help you manage the condition.
The part of your body affected by lymphoedema is more vulnerable to infection of the build-up of fluid within the tissues. Any cuts in your skin can allow bacteria to enter your body and may quickly develop into an infection. Skin infections can also damage your lymphatic system and cause lymphoedema to develop.
Lymph nodes act like a drain in your sink. If the drain is clogged, the fluid cannot drain. It usually happens in the arms or legs, but can occur in other parts of the body. Lymph fluid is part of the lymph system that carries fluid and cells that help fight infections throughout the body.
Other trauma to the lymphatic system, such as crushing injuries or burns, can disrupt drainage when lymphatic vessels or nodes are damaged. Scar tissue can create a barrier that prevents proper drainage. The swelling of lymphedema can develop quickly or progress over several months.
Although cancer treatments, including oncologic surgical procedures such as axillary lymph node dissection and excision in breast cancer and radiation treatment, are the most common cause of lymphedema in the United States, filariasis is the most common cause of secondary lymphedema globally.
Lymphedema occurs when the lymph system is damaged or blocked. Fluid builds up in soft body tissues and causes swelling. It is a common problem that may be caused by cancer and cancer treatment. Lymphedema usually affects an arm or leg, but it can also affect other parts of the body.
Lymphedema complications may include: Skin infections (cellulitis). The trapped fluid provides fertile ground for germs, and the smallest injury to the arm or leg can be an entry point for infection. Affected skin appears swollen and red and is typically painful and warm to the touch.
The final stage of lymphedema is sometimes called lymphostatic elephantiasis, which refers to the engorged swelling of a limb due to persistent lymph fluid buildup. The skin stretches, thickens, becomes hard and tight, and changes color.
STAGE II ( spontaneously irreversible stage)
There is increased swelling, which is not reduced by elevating the affected limb. The tissue is hardened and thickened; fibrosis and sclerosis have developed.
Stage 2 (irreversible lymphedema): Fibrosis — the deposition of loose, disorganized collagen tissue — has occurred. Without intervention, no matter how long the patient elevates or compresses the affected body part, it will not return to baseline contour and volume.
Complex Decongestive Therapy (CDT) is the gold standard for treating lymphedema and consists of a decongestion phase, followed by a maintenance phase. There are several parts to both phases, and all are essential to achieve the best possible outcomes.
Levels of a set of proteins circulating in the blood may accurately flag the presence of lymphedema, which currently is difficult to diagnose before the onset of physical symptoms.
A mild type of lymphedema can occur within a few days after surgery and usually lasts a short time. Lymphedema can also occur about 4 to 6 weeks after surgery or radiation and then go away over time. The most common type of lymphedema is painless and may slowly develop 18 to 24 months or more after surgery.