What Causes Lymphedema? Lymphedema refers to the soft tissue fluid on the surface of the body being repeatedly infected after lymphatic fluid return is obstructed in a certain part of the body. Subsequently, subcutaneous fibrous connective tissue proliferates and fat hardens. If it occurs in the limbs, they will thicken. In later stages, the skin thickens, becomes rough, and tough like elephant skin, which is commonly known as "elephant leg" among the general public. Below, we invite experts from Shanxi Yikang Peripheral Vascular Hospital to introduce what causes lymphedema.
(I) Etiology of Lymphedema
Primary lymphedema (Milroy's disease) is an autosomal dominant genetic disorder that may be related to abnormal embryonic development. Secondary lymphedema is caused by factors such as malignant tumor compression, surgical damage, radiation therapy, filariasis, lymph node excision, and various infections that lead to lymphatic obstruction. After several months or even years, local lymphedema begins to appear. Lymphedema is more common in tropical regions, but sometimes no cause can be found. In some countries, filariasis is one of the causes of lymphedema. Although the role of bacterial infection in causing lymphatic obstruction is uncertain, recurrent erysipelas and chronic cellulitis can damage lymphatics and further accelerate the progression of the disease. Similar lesions can also occur in tissues around chronic ulcers.
(II) Pathogenesis of Lymphedema
Lymph is the interstitial fluid between cells that returns to the veins through lymphatic vessels. The lymphatic circulation is also one of the physiological functional body circulations. Congenital maldevelopment of the lymphatic system or obstruction or destruction due to certain reasons leads to impaired lymphatic return in distal areas. This results in an abnormally increased amount of lymph fluid in the interstitial spaces. If it occurs in the limbs, the affected limb uniformly thickens. Initially, the skin is still smooth and soft, and elevating the affected limb can significantly reduce edema. Since the accumulated lymph fluid is rich in protein, it can reach as high as 5.8g/dl (normal is 0.72g/dl). Long-term stimulation leads to abnormal proliferation of connective tissue, with fatty tissues being replaced by a large amount of fibrous tissue. The skin and subcutaneous tissues are extremely thickened, with keratosis, roughness, and no indentation upon pressing. Wart-like hyperplasia appears, forming typical "elephantiasis." Infections increase inflammatory exudation, stimulating massive proliferation of connective tissue, destroying more lymphatics, exacerbating lymphatic retention, increasing opportunities for secondary infections, and forming a vicious cycle, leading to the worsening of lymphedema.
The histopathology of lymphedema: In primary lymphedema, the main lesion is in the dermal reticular layer and subcutaneous tissue, where there is more lymph fluid in the interstitial spaces. Collagen fibers in the dermal papillary layer show hyaline degeneration. There are varying degrees of lymphocyte infiltration around the blood vessels. In the early stage of secondary lymphedema, there is inflammatory cell infiltration, and in the late stage, tissue fibrosis occurs with wart-like hyperplasia of the epidermis.
What causes lymphedema? The above is a detailed introduction by experts on what causes lymphedema, hoping it helps you. If you have more questions, you can consult online with experts from Shanxi Yikang Peripheral Vascular Hospital. Finally, wishing you good health.
For more details, please visit the lymphedema section of Shanxi Yikang Peripheral Vascular Hospital: http://www.sxykmgy.com/linbashuizhong/ or consult experts for free. Experts will provide detailed answers based on the specific conditions of patients.
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