Classification of lymphostasis and lymphedema

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Lymphedema (lymphostasis) is a chronic progressive disease that occurs due to a violation of the transport of lymphatic fluid and is accompanied by an increase in limb volume as a result of the accumulation of rich protein in the intercellular space of the fluid.

There are many classifications of lymphedema, but at the moment the most modern and complete classification proposed by E. Foeldi and M. Foeldi in 1991.

According to the first classification according to M. Foeldi, lymphedema happens:

• malignant - lymphedema due to impaired lymph transport caused by a malignant process in the body (oncological process).
• benign - these are all other lymphedema that are not related to the oncological process.
   

According to the second second classification according to M. Foeldi, primary and secondary lymphedema are distinguished.

Primary happens: congenital, early (manifestation up to 35 years), late (manifestation after 35 years)
Secondary lymphedema is a consequence of: inflammatory diseases of the lymphatic system, injuries, surgical interventions, a consequence of the treatment of cancer.
 

In the process of developing lymphedema, the following stages are distinguished:

• 0 stage - latent. There are morphological changes in the tissues, but the edema is still absent, or is very poorly expressed
• Stage 1 - independently reversible. Overnight, swelling may decrease or disappear completely. At this stage, the edema is soft, the skin is smooth, with pressure in the area of ​​the edema, a fossa remains. Edema is noticeable in the evening after exercise, painless, causes heaviness in the limb. Against the background of Complex Physical Decongestant Therapy (CFT), edema can be completely eliminated. In the absence of proper treatment, the disease gradually goes into stage 2.
• Stage 2 - independently irreversible. Swelling does not decrease over night. The swelling is dense, the pit with pressure does not form as a result of pathogenic changes in the tissues. The skin looks like a lemon peel, dense. This stage is not reversible if you do not contact a lymphologist and do not carry out treatment.
• Stage 3 — elephantiasis. Edema is dense with trophic changes in the skin, hyperkeratosis, lichenization, papillomatous growths. Skin color changes are significant, deep folds appear, the anatomical contour of the limb changes and deforms.
   

  If the patient does not contact the specialist in time, complications of lymphedema may occur:

• heaviness and pain in the limb
• trophic skin changes (trophic ulcers and inductions)
• lymphorrhea and lymphangitis
• erysipelas
• elephantiasis
   

All of the above complications lead to disability of the patient and for a long period of time "knock" out of the usual rhythm of life. Do not delay the treatment, sign up for a consultation with a lymphologist today!

Author: Rasul Zade Sona Tarielovna MD ©