stages_of_lymphedema

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Lymphedema Stages
- WHAT ARE THE STAGES OF LYMPHEDEMA?
Lymphedema can also be categorized by its severity
- STAGES OF LYMPHEDEMA
Proposed Stage 4
External Links
- STAGES OF LYMPHEDEMA ACCORDING TO CORRELATION AMONG PATHOPHYSIOLOGY, CLINICAL FEATURES, IMAGING AND MORPHOLOGY OF THE AFFECTED LIMBS
- Diagnosis of an early (latent) stage of secondary lymphedema of the arm - a necessary condition for its successful treatment
CERTIFIED LYMPHEDEMA SCHOOLS OF THERAPY AND TREATMENT
PATIENT LYMPHEDEMA WEBSITES AND BLOGS
LYMPHEDEMA PEOPLE RELATED MEDICAL CONDITIONS BLOGS AND WEBSITES
MEDICAL GLOSSARIES
Lymphedema People Forums

Lymphedema Stages

WHAT ARE THE STAGES OF LYMPHEDEMA?

There are three basic stages active of lymphedema. The earlier lymphedema is recognized and diagnosed, the easier it is to successful treat it and to avoid many of the complications..

It is important as well to be aware that when you have lymphedema, even in one limb there is always the possibility of another limb being affected at some later time. This “inactive” period referred to as the latency stage. It is associated with hereditary forms of lymphedema.

LATENCY STAGE

Lymphatic transport capacity is reduced No visible/palpable edema Subjective complaints are possible

STAGE I

(Reversible Lymphedema) Accumulation of protein rich edema fluid Pitting edema Reduces with elevation (no fibrosis)

STAGE II

(Spontaneously Irreversible Lymphedema) Accumulation of protein rich edema fluid Pitting becomes progressively more difficult Connective tissue proliferation (fibrosis)

STAGE III

(Lymphostatic Elephantiasis) Accumulation of protein rich edema fluid Non pitting Fibrosis and sclerosis (severe induration) Skin changes (papillomas, hyperkeratosis, etc.)

Lymphedema can also be categorized by its severity

Grade 1 (mild edema): Lymphedema involves the distal parts such as a forearm and hand or a lower leg and foot. The difference in circumference is less than 4 centimeters, and other tissue changes are not yet present.

•Grade 2 (moderate edema): Lymphedema involves an entire limb or corresponding quadrant of the trunk. Difference in circumference is more than 4 but less than 6 centimeters. Tissue changes, such as pitting, are apparent. The patient may experience erysipelas.

•Grade 3a (severe edema): Lymphedema is present in one limb and its associated trunk quadrant. The difference in circumference is greater than 6 centimeters. Significant skin alterations, such as cornification or keratosis, cysts and/or fistulae, are present. Additionally the patient may experience repeated attacks of erysipelas.

•Grade 3b (massive edema): The same symptoms as Stage 3a except that two or more extremities are affected.

•Grade 4 (gigantic edema): Also known as elephantiasis. In this stage of lymphedema, the affected extremities are huge due to almost complete blockage of the lymph channels. Elephantiasis may also affect the head and face.

STAGES OF LYMPHEDEMA

Stage 1 (mild) - Upon waking in the morning the limb or affected area is almost a normal size. The tissue is still in a “pitting stage” ( when pressed by a finger the area indents and holds the indentation).

Stage 2 (moderate) - The tissue is “non-pitting” (when pressed by a finger the tissue bounces back without leaving an indentation). The tissue has a spongy consistency.

Stage 3 (severe) - The tissue at this stage is hard (fibrotic) and will be only slightly responsive to the touch. The swelling is almost irreversible and the limb is very large and swollen. Infections are possible at any stage of lymphedema but occurrence becomes greater as stages progress. A swollen limb, left untreated, becomes hard (fibrotic) and full of lymph fluid which is high in protein and a perfect medium for bacteria and infections.

Proposed Stage 4

03/10/04 Proposed

Discussion Stage Four:

There have been some voices raised about a Stage Four classification for lymphedema. From my personal experiences, I concur. Both my legs are classified as Stage Three, yet the difference between the two is very dramatic.

Stage Four Classification

The limb is so densely fibrotic that it is not possible to make any indentation when pressed. It becomes impossible for ultrasound testing to pick even the blood pulse. The skin becomes brittle and even the slight of bumps causes a serious, extensively weeping wound. Because of the hardness of the tissue, it has become a total septic foci for bacteria and constant cellulitis and systemic infections become the norm. The only treatment for cellulitis is an extended period of IV antibiotics.

There is no treatment option for Stage Four. The complete focus is on management, containment of infections, prevention if at all possible of amputation.

External Links

STAGES OF LYMPHEDEMA ACCORDING TO CORRELATION AMONG PATHOPHYSIOLOGY, CLINICAL FEATURES, IMAGING AND MORPHOLOGY OF THE AFFECTED LIMBS

AUTHOR: Salvador Nieto, M.D, FICA.

SALVADOR NIETO FOUNDATION “for the development of lymphedematology”. Av. Santa Fe 2679, 2º “D”; (1425) Buenos Aires. Argentina. PAPER PRESENTED IN THE 19º INTERNATIONAL CONGRESS OF LYMPHOLOGY - SEPTEMBER 4-6, 2003 - FREIBURG, GERMANY.

http://www.fundacionsnieto.com/t12ing.htm

Diagnosis of an early (latent) stage of secondary lymphedema of the arm - a necessary condition for its successful treatment

http://www.mucos.cz/eng/onko/dessla_e.html

CERTIFIED LYMPHEDEMA SCHOOLS OF THERAPY AND TREATMENT

The Vodder School - North America

Klose Training and Consulting

Academy of Lymphatic Studies

Norton School of Lymphatic Therapy

Coast to Coast School of Lymphedema Management

PATIENT LYMPHEDEMA WEBSITES AND BLOGS

LymphBaby

Lymphedema Art Journal

The Lymphedema Blog

Zachary

LYMPHEDEMA PEOPLE RELATED MEDICAL CONDITIONS BLOGS AND WEBSITES

My Life with Lymphedema

http://mylifewithlymphedema.blogspot.com/

Developmental Disorders of the Lymphatics

http://lymphsystemdisorders.blogspot.com

Edema and Related Medical Conditions

http://edemainformation.blogspot.com/

Lymphedemaville - AOL Blog

http://journals.aol.com/patoco2/Lymphedemaville

Disorders of the Lymph System

http://journals.aol.com/patoco2/DisordersoftheLymphSystem

Bacterial Infections

http://bacteriainfections.blogspot.com

Antibiotics

http://antibioticinformation.blogspot.com/

Fungus Infections

http://journals.aol.com/patoco2/FungusInfections

Cellulitis

http://cellulitisinfections.blogspot.com/

Trisomy Disorders

http://journals.aol.com/patoco2/TrisomyDisorders/

Lipedema

http://www.xanga.com/lipedema

Lymphangiectasia/Xanga

http://www.xanga.com/lymphangiectasia

Lymphangiectasia

http://lymphangiectasia.blogspot.com/

Lymphedema

http://www.xanga.com/lymphedema

Lymphedema

http://lymphedemahome.livejournal.com/

MEDICAL GLOSSARIES

Antibiotic Glossary

http://www.lymphedemapeople.com/phpBB3/viewforum.php?f=34

Blood Glossary

http://www.lymphedemapeople.com/phpBB3/viewforum.php?f=35

Cancer Glossary

http://www.lymphedemapeople.com/phpBB3/viewforum.php?f=36

Clinical Trials Glossary

http://www.lymphedemapeople.com/phpBB3/viewforum.php?f=41

Diet Glossary

http://www.lymphedemapeople.com/phpBB3/viewforum.php?f=37

Edema Glossary

http://www.lymphedemapeople.com/phpBB3/viewforum.php?f=38

Genetics Glossary

http://www.lymphedemapeople.com/phpBB3/viewforum.php?f=39

Immune System Glossary

http://www.lymphedemapeople.com/phpBB3/viewforum.php?f=40

Skin Glossary

http://www.lymphedemapeople.com/phpBB3/viewforum.php?f=42

Wound Glossary

http://www.lymphedemapeople.com/phpBB3/viewforum.php?f=44

Vitamin Glossary

http://www.lymphedemapeople.com/phpBB3/viewforum.php?f=43

Lymphedema People Forums

In our forums section, you will find over 3,000 posts with hundreds of additional articles encompassing every aspect of lymphedema you can imagine. Information, questions and answers that will enable you to discover not only how to live with lymphedema, but to manage it, overcome it and lead a life that is rich, meaningful and rewarding.

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http://www.lymphedemapeople.com/phpBB2/viewforum.php?f=2

Registry of Lymphedema Doctors

http://www.lymphedemapeople.com/phpBB2/viewforum.php?f=25

Lighthouse Lymphedema Network Lymphedema Education & Awareness Program

http://www.lymphedemapeople.com/phpBB2/viewforum.php?f=33

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