Primary upper‐limb lymphoedema. (20th November 2012)

• Record Type: Journal Article
• Authors: Vignes, S.; Arrault, M.; Yannoutsos, A.; Blanchard, M.
• Is Part Of: British journal of dermatology. Volume 168:Number 2(2013:Feb.)
• Page Start: 272
• Page End: 276
• Publication Date: 2012-11-20
• Subjects: Dermatology -- Periodicals; Skin -- Diseases -- Periodicals; 616.5
• DOI: 10.1111/bjd.12024
• Languages: English
• ISSNs: 0007-0963

Abstract

<abstract abstract-type="main" xml:lang="en"> <title> <x xml:space="preserve">Abstract</x> </title> <p> <bold>Summary</bold> <bold> Background </bold> Lymphoedema is a general term used to designate pathological, regional accumulation of protein‐rich fluid. It can be either primary or secondary, and mainly occurs after cancer treatment.</p> <p> <bold>Objectives </bold> To analyse the clinical and lymphoscintigraphic characteristics of primary upper‐limb lymphoedema (ULL).</p> <p> <bold>Methods </bold> All of the patients with ULL were recruited at a single Department of Lymphology between January 2007 and December 2011.</p> <p> <bold>Results </bold> In total, 60 patients (33 female, 27 male) were enrolled. For the 54 noncongenital lymphoedemas, the mean age at onset was 38·5 (range 3–82) years. Lymphoedema was unilateral in 51 patients (85%). It always affected the hand, and less often the forearm (55%) or upper arm (23%). Eleven patients (18%) developed cellulitis after onset of lymphoedema, and 21 patients (35%) had associated lower‐limb lymphoedema (LLL). Forty‐six patients (with 49 lymphoedematous limbs) underwent lymphoscintigraphy: axillary lymph node uptake was diminished in 18 (37%), absent in 24 (49%) and normal in seven limbs (14%). Among the 43 patients with unilateral lymphoedema and lymphoscintigraphy, 28 had epitrochlear node visualization, suggesting a rerouting through the deep lymphatic system, with 15 only on the lymphoedematous limb and 22 on the contralateral nonlymphoedematous limb. The median follow‐up period was 103 months, and 57/60 patients (95%) considered their lymphoedema to be stable.</p> <p> <bold>Conclusions </bold> Primary ULL appears later in life than LLL, without predominance in either sex. Infectious complications are rare and patients considered the lymphoedema volume stable throughout life.</p> </abstract>