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THE CONDITION
To understand what lymphoedema is, it is helpful to briefly mention how the lymphatic system is composed.
In the tissues of our body, it is completely normal for small amounts of fluid to continuously form that are not reabsorbed by the venous capillary circulation.
This fluid is then collected by other small vessels present in the tissues, called lymphatic vessels.
These vessels drain lymph towards the lymph nodes, which are true organs. This system has a crucial role in regulating the immune defences of our body and protects us from external aggressions such as bacteria, viruses, etc.
However, when the lymphatic system no longer functions properly, lymph accumulates in the tissues, leading to lymphatic stasis and subsequently lymphoedema.
Thus, lymphoedema is a chronic condition caused by abnormalities in the lymphatic system. It is characterized by a slowdown or blockage of lymphatic circulation. It primarily affects the limbs and can manifest on one or both sides, but it can also involve other body areas.
Lymphoedema can be classified as PRIMARY or SECONDARY.
PRIMARY AND SECONDARY LYMPHOEDEMA
Primary lymphoedema can be caused by a congenital defect and may be characterised by early-onset (when it appears before the age of 35, accounting for 65-80% of cases) or late-onset (when it appears after the age of 35).
Secondary lymphoedema is usually caused by oncological surgical treatment.
In men, it can also be caused by a prostatectomy (surgical removal of the prostate).
In the upper limb, both in men and women, lymphoedema occurs in 60% of cases within the first two years after surgery.
In the lower limb, on the other hand, both in men and women, it occurs in about 80% of cases within one year of the procedure.
To accurately determine the type of lymphoedema one is affected by and its stage, it is necessary to have an initial lymphological consultation.
SYMPTOMS OF LYMPHOEDEMA
Lymphoedema manifests as localized swelling in the affected areas, which are usually the arms or legs. It is typically asymmetric, meaning it develops in one limb at a time, but there can be cases of lymphoedema in both legs or arms.
In the case of secondary lymphedema, the swelling can also affect the face, neck, chest, and genital organs.
Sometimes, the swelling can appear suddenly with rapid progression; other times, it may develop more insidiously, with imperceptible progression until it degenerates into extreme swelling of the limb.
Lymphoedema is a condition that can lead to difficulty in walking and can have serious tissue and clinical complications, such as fibrosis, infections, and skin lesions that can progress to ulcers.
The limb affected by lymphoedema is indeed at a significantly higher risk of infections, even from minor wounds, burns, or insect bites. The risk of complications in lymphoedema reaches 75% in the more advanced stages of the condition.
In summary, the typical symptoms of lymphoedema, in most cases, include: swelling and heaviness of the limb, thickening of the skin, difficulty in movement, increased susceptibility to infections, and the skin of the affected limb may appear shinier and paler.
