Paediatrics: Lymphoedema

Lymphoedema

Diffuse soft tissue oedema due to inadequate lymphatic drainage. May be due to developmental defect, e.g. congenital lymphoedema (isolated or part of Turner’s syndrome) or cystic hygroma (which also commonly has a vascular component). Secondary causes include—surgical lymphatic destruction; malignant infiltration; irradiation; recurrent lymphangitis; par-asitic infestation (in the tropics—filariasis or elephantiasis).

Presentation

·Pitting firm swelling.

·+/– Hypertrophy of affected limb.

·Lymphangiography may be helpful to identify the area of obstruction.

Treatment

Is often difficult. Limb elevation, pressure garments, or diuretics may be helpful. Give oral penicillin prophylaxis for increased risk of erysipelas