Although not reported as often as postmastectomy-induced lymphedema, obesity is also one of the most common causes of lymphedema seen in practice today. The primary lymphedemas occur in 1 of 10,000 individuals, with lymphedema praecox accounting for 80% of cases. The incidence of congenital lymphedema is unknown because most patients have been reported in small, case-based studies. Primary lymphedema occurs most often in females. Lymphedema praecox, the most common primary form, affects 1 in 100,000 females and 1 in 400,000 males. Similarly, females account for 70-80% of cases of congenital lymphedema. Secondary lymphedema can affect persons of any age group, with the onset being determined by the disease?s primary cause.
Signs and symptoms of edema include: Swelling or puffiness of the tissue directly under your skin, Stretched or shiny skin, Skin that retains a dimple after being pressed for several seconds, increased abdominal size. Mild edema usually goes away on its own, particularly if you help things along by raising the affected limb higher than your heart. More severe edema may be treated with drugs that help your body expel excess fluid in the form of urine (diuretics). One of the most common diuretics is furosemide (Lasix).
Lymphedema is an abnormal collection of protein-rich fluid in the interstitium resulting from obstruction of lymphatic drainage. Lymphatic obstruction causes an increase in the protein content of the extravascular tissue, with subsequent retention of water and swelling of the soft tissue. The increase in the extravascular protein stimulates proliferation of fibroblasts, organization of the fluid, and the development of a nonpitting swelling of the affected extremity. The normal function of the lymphatics is to return proteins, lipids, and water from the interstitium to the intravascular space; 40-50% of serum proteins are transported by this route each day. The overlying skin becomes thickened and displays the typical peau d'orange (orange skin) appearance of congested dermal lymphatics.