Disorders of the lymphatics
The skin overlying chronic lymphoedema is firm and pits poorly. Longstanding lymphoedema may lead to gross, almost furry, hyperkeratosis, as in the so-called ‘mossy foot’.
This streptococcal infection of the lymphatics may occur without any lymphoedema. A tender red line extends proximally. Penicillin flucloxacillin, cephalexin and erythromycin are usually effective.