MES MUNDIAL DE CONCIENCIACIÓN DEL LIPEDEMA - Junio 2022 - Miembro de FEDEAL, la Federación de Asociaciones Españolas de Lipedema

Junio es el Mes de la Concienciación sobre el Lipedema, que nos da la oportunidad de visibilizar y hacer del lipedema una prioridad mundial. El lipedema es una enfermedad crónica, dolorosa y progresiva del tejido adiposo que afecta a más del 11% de las mujeres de todo el mundo, y se caracteriza por una hinchazón e inflamación simétrica bilateral de las piernas, muslos y caderas, y desproporcionada con respecto al resto del cuerpo.

Los médicos y los pacientes suelen confundir el lipedema con la obesidad general o el linfedema. Lea más información sobre los síntomas y el tratamiento para Lipedema AQUÍ.

WORLD LIPEDEMA AWARENESS MONTH - June 2022 - Member of FEDEAL, the Federation of Spanish Lipedema Associations

June is Lipedema Awareness Month, which gives us the chance to raise awareness and make lipedema a global priority. Lipedema is a progressive painful chronic disease of fat tissue that affects more than 11% of women worldwide, and is characterized by bilateral symmetrical swelling of the legs, thighs, and hips, and is disproportionate to the rest of the body. 

Clinicians and patients commonly confuse Lipedema with general obesity or lymphedema. Read more information about Lipedema symptoms and treatment HERE.

¿CUAL ES EL IMPACTO PSICOLÓGICO Y DE CALIDAD DE VIDA RELACIONADO AL NO TRATAMIENTO O INFRATRATAMIENTO DEL LINFEDEMA? - Enfermedad Linfático-Vascular Orgánica - Linfedema Pediátrico y Primario - Linfedema Secundario - Filariasis Linfática y Podoconiosis - Mejor Tratamiento de Primera Línea - Terapia Descongestiva Completa (CDT) - Enfermedad de la Piel

Factores de estrés psicológico en el linfedema deben tenerse en cuenta en relación con los indicadores de Calidad de Vida (CdV) de los individuos. El linfedema no es en sí mismo una psicopatología, ni predispone sin más a una mala salud mental. En muchos casos, la situación negativa del no tratamiento o de infratratamiento del linfedema conducen al aumento de la progresión de la enfermedad y, contribuye al ciclo de discapacidad, desfiguración, estigmatización social, pobreza, sufrimiento y, la carga asociada al bienestar físico, económico, social y psicológico de las personas. Lea más información sobre aspectos psicológicos que rodean el no tratamiento o el infratratamiento del linfedema AQUÍ.

El linfedema (Enfermedad Linfático Vascular Orgánica) se debe a un drenaje linfático deficiente que provoca enfermedad de la piel, caracterizada por una hinchazón progresiva y un engrosamiento anormal de la piel y tejido conjuntivo subcutáneo. El linfedema no es sólo un problema de hinchazón localizada, sino una afección que puede afectar a múltiples sistemas, estructuras y funciones corporales, dando lugar a una serie de síntomas y complicaciones físicas, fisiológicas y psicosociales. Lea sobre los síntomas y complicaciones del linfedema AQUÍ.

El linfedema surge cuando hay una interrupción del flujo linfático (Discapacidad Orgánica), lo que provoca la acumulación de líquido linfático. Está claro que ningún paciente ni su linfedema son iguales, como tampoco lo son su progresión. Algunos pacientes con linfedema en las extremidades tienen pocas limitaciones y pueden realizar con facilidad distintos grados de actividad física, mientras que otros sienten el esfuerzo, padecen complicaciones y experimentan un aumento de la hinchazón con el mínimo esfuerzo.

En cuanto linfedema debido a filariasis, el  Índice de Calidad de Vida en Dermatología (DLQI) y el Cuestionario de Calidad de Vida en la Filariasis Linfática (LFSQQ), para evaluar la Calidad de Vida Relacionada con la Salud (CVRS) percibida por los individuos tras su participación en el tratamiento del linfedema, debería incluir si los pacientes tienen acceso a un tratamiento adecuado. Los pacientes que tienen acceso sólo a pomadas antisépticas y medicación antibiótica pueden notar una mejora, pero esto no debería considerarse una mejora real en las puntuaciones de calidad de vida, porque estas soluciones no están abordando el problema de fondo que es la disfunción linfática subyacente. A largo plazo, sin la terapia linfática y las prendas de compresión, la condición seguirá empeorando para la mayoría de los pacientes, así como sus consecuentes y múltiples problemas psicosociales. Lea más sobre los signos, síntomas  y complicaciones del linfedema AQUÍ.

QUE ES LA ELEFANTIASIS / MITOS Y REALIDADES

El imponer a pacientes la aceptación y el ser complacientes con opciones de tratamiento alternativos de bajo coste, puede ser cuestionable a nivel ético y de Derechos Humanos, ya que muchas de estas opciones de gestión son a menudo ineficaces para reducir y mantener el volumen del edema, o incluso pueden tener efectos secundarios graves a largo plazo. Ésta situación puede a su vez ser causa de mayor angustia psicológica y, deterioro de la Calidad de Vida (CdV) relacionada con la salud. El linfedema es debido a una disfunción del sistema circulatorio linfático (Enfermedad linfático-Vascular Orgánica), que en la mayoría de casos necesita tratamiento de por vida. 

AVISO IMPORTANTE 

El Linfedema es una enfermedad crónica y progresiva debido a una disfunción linfática (Enfermedad Linfático-Vascular Orgánica). El tratamiento clínico del linfedema no es ni un tratamiento cosmético ni estético. El tratamiento del linfedema es para controlar su avance y aliviar los síntomas relacionados con la disfunción del sistema circulatorio linfático. 

Para prevenir y evitar problemas graves asociados al tratamiento, como el posible desplazamiento del edema a zonas previamente no afectadas cuando se aplica la terapia de compresión para la reducción del volumen, los pacientes deben recurrir a terapeutas altamente especializados con experiencia. 

La cualificación profesional y la instrucción impartida a distancia en línea no son lo mismo que la instrucción práctica en directo en la formación clínica y la certificación de los terapeutas del linfedema, similar a todos los demás programas de formación en rehabilitación, medicina y cirugía, y especialmente para desarrollar las habilidades manuales necesarias para tratar una enfermedad tan compleja como el linfedema.

Los pacientes deben igualmente tener un especial cuidado a la hora de elegir un "Centro Multidisciplinar de Referencia de Linfedema", ya que no todos los países o centros de referencia proporcionan las mismas opciones de tratamiento. La mejor elección es un centro de referencia que aplica la Terapia Descongestiva Compleja (TDC), que está reconocida como el tratamiento "Estándar de Excelencia" para el linfedema.

• Lea más sobre la mejor opción de tratamiento para Linfedema AQUÍ.

• Lea sobre las principales funciones del Drenaje Linfático Manual AQUÍ.

• Lea sobre las diferencias entre los dos principales protocolos de tratamiento para Linfedema AQUÍ. 

• Lea sobre las estrategias para la aplicación de tratamientos de bajo coste para el linfedema AQUÍ.  

REFERENCIAS

(Pincha sobre los textos para leer los artículos científicos)

SOCIEDADES CIENTÍFICAS

• German Scientific Society Guideline: Diagnostics and Therapy of Lymphoedema.

FISIOPATOLOGÍA

• lymphedema.
• Biology of Lymphedema
• Lymph vessels: the forgotten second circulation in health and disease
• Lymphatic Vessel Network Structure and Physiology
• Lymphatic System Flows
• Organ-specific lymphatic vasculature: From development to pathophysiology.
• The lymphatic vascular system: much more than just a sewer.
• The unresolved pathophysiology of lymphedema.
• Lymphedema: A Practical Approach and Clinical Update.
• Coagulation in Lymphatic System.
• Regulation of immune function by the lymphatic system in lymphedema.
• Oxidative stress in chronic lymphoedema.
• Regulatory T Cells Mediate Local Immunosuppression in Lymphedema.
• Hemostatic properties of the lymph: relationships with occlusion and thrombosis.
• Secondary lymphedema: Pathogenesis
• Gastrointestinal Lymphatics in Health and Disease
• Intestinal lymphangiectasia in adults
• Role of the lymphatic vasculature in cardiovascular medicine
• The lymphatic vasculature in disease
• Lymphoscintigraphic abnormalities in the contralateral lower limbs of patients with unilateral lymphedema.
• The Prevalence of Lower Limb and Genital Lymphedema after Prostate Cancer Treatment: A Systematic Review
• Peripheral Edema

COMPLICACIONES CUTÁNEAS

• The lymphatic system and the skin. Classification, clinical aspects, and histology.
• Lymphedema and cutaneous diseases.
• Lymphedema and subclinical lymphostasis (microlymphedema) facilitate cutaneous infection, inflammatory dermatoses, and neoplasia: A locus minoris resistentiae.
• Serum Immune Proteins in Limb Lymphedema Reflecting Tissue Processes Caused by Lymph Stasis and Chronic Dermato-lymphangio-adenitis (Cellulitis).
• Lymphedema and subclinical lymphostasis (microlymphedema) facilitate cutaneous infection, inflammatory dermatoses, and neoplasia: A locus minoris resistentiae.

COMPLICACIONES INFECCIOSAS

• Lymphatic Flow: A Potential Target in Sepsis.
• Infectious complications of lymphedema.
• Acute inflammatory exacerbations in lymphoedema.
• Inflammatory Manifestations of lymphedema.

CELULITIS / DERMATOLINFANGIOADENITIS

• Cellulitis.
• Clinical features, microbiological epidemiology, and recommendations for the management of cellulitis in extremity lymphedema.
• Challenges of cellulitis in a lymphedematous extremity.
• Diagnosis and management of cellulitis.
• Cellulitis risk factors for patients with primary or secondary lymphedema.
• Oedema as a risk factor for multiple episodes of cellulitis/erysipelas of the lower leg.
• Prevention of dermatolymphangioadenitis by combined physiotherapy.
• Erysipelas: a common potentially dangerous infection.

TUMORES

• Malignant tumors as complications of lymphedema.
• Lymphedematous areas: Privileged sites for tumors, infections, and immune disorders.
• Lymphedema-related angiogenic tumors and other malignancies.
• Lymphedema: an immunologically vulnerable site for the development of neoplasms.
• Lymph stasis promotes tumor growth
• A retrospective analysis of Stewart-Treves syndrome in the context of chronic lymphedema.
• Stewart-Treves Syndrome

DOLOR

• Congenital lymphedema complicated by pain and psychological distress: case report
• Lymphatic Pain in Breast Cancer Survivors
• Does Manual Lymphatic Drainage Have Any Effect on Pain Threshold and Tolerance of Different Body Parts?
• Lymphedema therapy reduces the volume of edema and pain in patients with breast cancer
• Quality of life in patients with primary and secondary lymphedema in the community

TRATAMIENTO

• Treatment of limbs lymphedema.
• Nonoperative treatment of lymphedema.
• Lymphedema: From diagnosis to treatment.
• Lymphedema-clinical picture and therapy.
• Physiotherapeutic rehabilitation of lymphedema: state-of-the-art.
• Diagnosis and management of lymphatic vascular disease
• Effective treatment of lymphedema of the extremities.
• Lymphoscintigraphic aspects of the effects of manual lymphatic drainage.
• Intensive Treatment of Lower-Limb Lymphedema and Variations in Volume.
• Effectiveness and safety of Complete Decongestive Therapy of Phase I.
• Therapeutic Efficacy of Complex Decongestive Therapy in the Treatment of Elephantiasis of the Lower Extremities.
• Effects of Phase I complex decongestive physiotherapy on physical functions and depression levels in breast cancer-related lymph edema.
• Does lymphoedema bandaging reduce the risk of toe ulceration?
• Study of 700 referrals to a Lymphedema Program.
• Worldwide assessment of healthcare personnel dealing with lymphoedema.
• Földi M, Földi E. Földi’s textbook of lymphology for physicians and Lymphoedema therapists.
• Fluid Shifts Induced by Physical Therapy in Lower Limb Lymphedema Patients
• Visualization of Accessory Lymphatic Pathways, before and after Manual Drainage, in Secondary Upper Limb Lymphedema Using Indocyanine Green Lymphography
• The risk of genital edema after external pump compression for lower limb lymphedema.
• The management of genital lymphoedema
• The management of deep vein thrombosis in lymphoedema: a review.
• Lymphedema-associated comorbidities and treatment gap.

PRENDAS DE COMPRESIÓN

• A study of the advantages of elastic stockings for leg lymphedema.
• Indications for medical compression stockings in venous and lymphatic disorders: An evidence-based consensus statement.
• Medical compression stockings for chronic venous diseases and lymphedema: Scientific evidence and results of a patient survey on quality of care.
• Impact of Compression Therapy on Cellulitis (ICTOC) in adults with chronic edema: a randomized controlled trial protocol.
• Compression Therapy Is Cost-Saving in the Prevention of Lower Limb Recurrent Cellulitis in Patients with Chronic Edema.
• Occupational leg edema-use of compression stockings.

DISCAPACIDAD

• Disability and lymphedema.
• Lymphedema and employability.
• Worse and worse off: the impact of lymphedema on work and career after breast cancer
• Functioning in lymphedema from the patient's perspective using the International Classification of Functioning, Disability and Health (ICF).
• Unilateral upper extremity lymphedema deteriorates the postural stability in breast cancer survivors
• Postural Stability in Patients with Lower Limb Lymphedema
• Disability, psychological distress and quality of life in breast cancer survivors with arm lymphedema

DISFIGURACIÓN

• Adjusting to disfigurement: processes involved in dealing with being visibly different
• Quality of Life in Cancer Patients with Disfigurement due to Cancer and its Treatments
• Quality-of-life and body image impairments in patients with lymphedema
• Association of lower extremity lymphedema with pelvic floor functions, sleep quality, kinesiophobia, body image in patients with gynecological cancers

CALIDAD DE VIDA

• The impact of lower limb chronic oedema on patients' quality of life
• Quality of life in patients with primary and secondary lymphedema in the community
• Evaluating the effect of upper-body morbidity on quality of life following breast cancer treatment.
• Functionality and quality of life of patients with unilateral lymphedema of a lower limb: a cross-sectional study
• The effect of complete decongestive therapy on the quality of life of patients with peripheral lymphedema

IMPACTO PSYCHOSOCIAL

• Psychosocial Impact of Lymphedema.
• Associations between chronic disease, age, and physical and mental health status
• A network analysis of psychological flexibility, coping, and stigma in dermatology patients
• 'Abandoned by medicine'? A qualitative study of women's experiences with lymphoedema secondary to cancer, and the implications for care
• People are neglected, not diseases.
• Chronic edema/lymphoedema: under-recognized and under‐treated.
• Lymphatic Medicine: Paradoxically and unnecessarily ignored.
• Medical education: a deficiency or a disgrace.

LINFEDEMA PEDIÁTRICO

• NORD: Rare Disease Database - Lymphedema
• Medical management of lymphedema.
• Primary lymphedema in childhood.
• An approach to familiar lymphedema
• Pediatric Children Lymphedema
• Primary Lymphedema French National Diagnosis and Care Protocol (PNDS).
• Lymphatic filariasis: an infection of childhood.
• Lymphatic filariasis in children: clinical features, infection burdens and future prospects for elimination.

FILARIASIS / PODOCONIOSIS LINFÁTICA

• Podoconiosis: Clinical spectrum and microscopic presentations.
• Podoconiosis: A Possible Cause of Lymphedema in Micronesia.
• A cross-sectional study to evaluate depression and quality of life among patients with lymphoedema due to podoconiosis, lymphatic filariasis, and leprosy.
• The impact of acute adenolymphangitis in podoconiosis on caregivers.
• Neglected tropical diseases and disability-what is the link?
• Locomotor disability in bancroftian filarial lymphoedema patients.
• Neglected patients with a neglected disease?
• Neglected tropical diseases and mental health: a perspective on comorbidity.
• People are neglected, not diseases.
• Addressing Inequity: Neglected Tropical Diseases and Human Rights.
• Neglected Tropical Diseases, Conflict, and the Right To Health.

SISTEMA VASCULAR SANGUÍNEO 

• Peripheral Edema
• Phlebolymphedema
• Understanding Chronic Venous Disease: A Critical Overview of Its Pathophysiology and Medical Management
• Role of the lymphatic vasculature in cardiovascular medicine
• Communication between lymphatic and venous systems
• Phlebopathies and occupation
• Phlebopathies and workers
• Evidence of health risks associated with prolonged standing at work and intervention effectiveness
• Leg edema formation and venous blood flow velocity during a simulated long-haul flight

Artículos relacionados que le pueden interesar: 

(Pincha sobre el texto)

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• CONSEJOS PARA VIAJES EN AUTO Y TREN

• CONSEJOS PARA VIAJES EN AVIÓN

• ASISTENCIA PSICOLÓGICA EN LINFEDEMA

• LA ELEFANTIASIS NO ES SOLO FILARIASIS LINFÁTIC 

• EXSISTE DOLOR EN LINFEDEMA 

• QUE PAÍS TIENE LA MEJOR COBERTURA SANITARIA PARA EL TRATAMIENTO DEL LINFEDEMA 

• CUAL ES EL MEJOR TRATAMIENTO PARA LINFEDEMA PEDIÁTRICO Y PRIMARIO 

• ASOCIACIONES ESPAÑOLAS DE LINFEDEMA – FEDERACION ESPAÑOLA DE ASOCIACIONES DE LINFEDEMA

INCIDENCIA Y PREVALENCIA 
DEL LINFEDEMA

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WHAT IS THE PSYCHOLOGICAL AND QUALITY OF LIFE IMPACT RELATED TO NON-TREATMENT OR UNDERTREATMENT IN LYMPHEDEMA? - ORGANIC LYMPHATIC VASCULAR DISEASE – Pediatric and Primary Lymphedema – Secondary Lymphedema – Lymphatic Filariasis & Podoconiosis – Best First Line Treatment – Complete Decongestive Therapy (CDT) - Disease of the Skin

Psychological stress factors in Lymphedema should be taken into consideration regarding the Quality of Life (QoL) indicators of individuals. Lymphedema is not in itself a psychopathology, nor does it simply predispose individuals to poor mental health. In many cases, the negative situation of non-treatment or under-treatment of lymphedema leads to increased disease progression and, contributes to the cycle of disability, disfigurement, social stigmatization, poverty, suffering, and thus, the associated burden on the physical, economic, social, and psychological well-being of individuals. Read more information about psychological aspects surrounding non-treatment or undertreatment of lymphedema HERE.

Lymphedema (Organic Lymphatic Vascular Disease) is due to impaired lymphatic drainage resulting in skin disease, characterized by persistent and progressive swelling, and abnormal thickening of the skin and subcutaneous connective tissue. Lymphedema is not just a localized swelling problem, but a condition that can affect multiple body systems, structures and functions, leading to a range of physical, physiological and psychosocial symptoms and complications. Read about the symptoms and complications of lymphedema HERE.

Lymphedema arises when there is a disruption of the lymphatic flow (Organic Impairment), leading to the buildup of lymphatic fluid.  It is clear that no patient or their lymphedema is the same and neither is its progress. Some patients with limb lymphedema have few limitations and can easily do different degrees of physical activity, while others feel the strain, experience complications, and experience increased swelling with minimum effort.

Regarding Lymphedema due to filariasis, the Dermatology Life Quality Index (DLQI), and the Lymphatic Filariasis Quality of Life Questionnaire (LFSQQ), to assess the perceived Health-Related Quality of Life (HRQoL) of individuals after participation in lymphedema management, should include if patients have access to proper treatment. Patients who have access to antiseptic creams and antibiotic medication may notice an improvement, but these solutions do not address the underlying lymphatic dysfunction problem. In the long run, without lymphatic therapy and compression garments, the condition will continue to worsen for most patients, as well as the consequent multiple psycho-social problems. Read more about the signs, symptoms, and complications of lymphoedema HERE.

WHAT IS ELEPHANTIASIS / MYTHS AND FACTS

Imposing patients to accept and be compliant with low-cost alternative treatment options may be questionable on ethical and "Human Rights" grounds, as many of these management options are often ineffective in maintaining edema volume, or may even have serious long-term side effects. This can in turn cause of furthermore psychological distress and, further impaired  Health-Related Quality of Life (QoL). Lymphedema is due to dysfunction of the lymphatic circulatory system (Organic Lymphatic Vascular Disease), which in most cases needs lifelong treatment. Read information about what is an Organic Impairment HERE.

IMPORTANT NOTICE 

Lymphedema is a serious chronic and progressive disease due to lymphatic dysfunction (Organic Lymphatic Vascular Disease). The clinical treatment of lymphedema is neither a cosmetic nor an aesthetic treatment. The treatment of lymphedema is to control its progression and alleviate the symptoms related to dysfunction of the lymphatic circulatory system. 

To prevent and avoid serious complications associated with treatment, such as the possible displacement of edema to previously unaffected areas when compression therapy is applied for volume reduction, patients should use highly specialized and experienced therapists. 

Professional qualification and instruction delivered remotely online are not the same as live hands-on practical instruction in the clinical training and certification of lymphedema therapists, similar to all other rehabilitation, medical, and surgical training programs, and especially for developing the necessary manual skills to treat a disease as complex as lymphedema. 

Patients should also take special care when choosing a "Multidisciplinary Expert Center of Reference for Lymphedema", as not all countries and centers provide the same treatment options. The best choice is a center of reference that provides Complete Decongestive Therapy (CDT), which is recognized as the “Gold Standard” treatment for lymphedema.

• Read more about the best treatment option for Lymphedema HERE.

• Read about the principal functions of Manual Lymphatic Drainage HERE.

• Read about the differences between the two principal lymphedema treatment protocols HERE. 

• Read about the strategies for the implementation of low-cost treatment options for Lymphedema HERE.

REFERENCES

(Click on the texts to read the research articles)

SCIENTIFIC SOCIETIES

• German Scientific Society Guideline: Diagnostics and Therapy of Lymphoedema.

PATHOPHYSIOLOGY

• lymphedema.
• Biology of Lymphedema
• Lymph vessels: the forgotten second circulation in health and disease
• Lymphatic Vessel Network Structure and Physiology
• Lymphatic System Flows
• Organ-specific lymphatic vasculature: From development to pathophysiology.
• The lymphatic vascular system: much more than just a sewer.
• The unresolved pathophysiology of lymphedema.
• Lymphedema: A Practical Approach and Clinical Update.
• Coagulation in Lymphatic System.
• Regulation of immune function by the lymphatic system in lymphedema.
• Oxidative stress in chronic lymphoedema.
• Regulatory T Cells Mediate Local Immunosuppression in Lymphedema.
• Hemostatic properties of the lymph: relationships with occlusion and thrombosis.
• Secondary lymphedema: Pathogenesis
• Gastrointestinal Lymphatics in Health and Disease
• Intestinal lymphangiectasia in adults
• Role of the lymphatic vasculature in cardiovascular medicine
• The lymphatic vasculature in disease
• Lymphoscintigraphic abnormalities in the contralateral lower limbs of patients with unilateral lymphedema.
• The Prevalence of Lower Limb and Genital Lymphedema after Prostate Cancer Treatment: A Systematic Review
• Peripheral Edema

CUTANEOUS COMPLICATIONS

• The lymphatic system and the skin. Classification, clinical aspects, and histology.
• Lymphedema and cutaneous diseases.
• Lymphedema and subclinical lymphostasis (microlymphedema) facilitate cutaneous infection, inflammatory dermatoses, and neoplasia: A locus minoris resistentiae.
• Serum Immune Proteins in Limb Lymphedema Reflecting Tissue Processes Caused by Lymph Stasis and Chronic Dermato-lymphangio-adenitis (Cellulitis).
• Lymphedema and subclinical lymphostasis (microlymphedema) facilitate cutaneous infection, inflammatory dermatoses, and neoplasia: A locus minoris resistentiae.

INFECTIOUS COMPLICATIONS

• Lymphatic Flow: A Potential Target in Sepsis.
• Infectious complications of lymphedema.
• Acute inflammatory exacerbations in lymphoedema.
• Inflammatory Manifestations of lymphedema.

CELLULITIS / DERMATOLYMPHANGIOADENITIS

• Cellulitis.
• Clinical features, microbiological epidemiology, and recommendations for the management of cellulitis in extremity lymphedema.
• Challenges of cellulitis in a lymphedematous extremity.
• Diagnosis and management of cellulitis.
• Cellulitis risk factors for patients with primary or secondary lymphedema.
• Oedema as a risk factor for multiple episodes of cellulitis/erysipelas of the lower leg.
• Prevention of dermatolymphangioadenitis by combined physiotherapy.
• Erysipelas: a common potentially dangerous infection.

TUMOURS

• Malignant tumors as complications of lymphedema.
• Lymphedematous areas: Privileged sites for tumors, infections, and immune disorders.
• Lymphedema-related angiogenic tumors and other malignancies.
• Lymphedema: an immunologically vulnerable site for the development of neoplasms.
• Lymph stasis promotes tumor growth
• A retrospective analysis of Stewart-Treves syndrome in the context of chronic lymphedema.
• Stewart-Treves Syndrome

PAIN

• Congenital lymphedema complicated by pain and psychological distress: case report
• Lymphatic Pain in Breast Cancer Survivors
• Does Manual Lymphatic Drainage Have Any Effect on Pain Threshold and Tolerance of Different Body Parts?
• Lymphedema therapy reduces the volume of edema and pain in patients with breast cancer
• Quality of life in patients with primary and secondary lymphedema in the community

TREATMENT

• Treatment of limbs lymphedema.
• Nonoperative treatment of lymphedema.
• Lymphedema: From diagnosis to treatment.
• Lymphedema-clinical picture and therapy.
• Physiotherapeutic rehabilitation of lymphedema: state-of-the-art.
• Diagnosis and management of lymphatic vascular disease
• Effective treatment of lymphedema of the extremities.
• Lymphoscintigraphic aspects of the effects of manual lymphatic drainage.
• Intensive Treatment of Lower-Limb Lymphedema and Variations in Volume.
• Effectiveness and safety of Complete Decongestive Therapy of Phase I.
• Therapeutic Efficacy of Complex Decongestive Therapy in the Treatment of Elephantiasis of the Lower Extremities.
• Effects of Phase I complex decongestive physiotherapy on physical functions and depression levels in breast cancer-related lymph edema.
• Does lymphoedema bandaging reduce the risk of toe ulceration?
• Study of 700 referrals to a Lymphedema Program.
• Worldwide assessment of healthcare personnel dealing with lymphoedema.
• Földi M, Földi E. Földi’s textbook of lymphology for physicians and Lymphoedema therapists.
• Fluid Shifts Induced by Physical Therapy in Lower Limb Lymphedema Patients
• Visualization of Accessory Lymphatic Pathways, before and after Manual Drainage, in Secondary Upper Limb Lymphedema Using Indocyanine Green Lymphography
• The risk of genital edema after external pump compression for lower limb lymphedema.
• The management of genital lymphoedema
• The management of deep vein thrombosis in lymphoedema: a review.
• Lymphedema-associated comorbidities and treatment gap.

COMPRESSION GARMENTS

• A study of the advantages of elastic stockings for leg lymphedema.
• Indications for medical compression stockings in venous and lymphatic disorders: An evidence-based consensus statement.
• Medical compression stockings for chronic venous diseases and lymphedema: Scientific evidence and results of a patient survey on quality of care.
• Impact of Compression Therapy on Cellulitis (ICTOC) in adults with chronic edema: a randomized controlled trial protocol.
• Compression Therapy Is Cost-Saving in the Prevention of Lower Limb Recurrent Cellulitis in Patients with Chronic Edema.
• Occupational leg edema-use of compression stockings.

DISABILITY

• Disability and lymphedema.
• Lymphedema and employability.
• Worse and worse off: the impact of lymphedema on work and career after breast cancer
• Functioning in lymphedema from the patient's perspective using the International Classification of Functioning, Disability and Health (ICF).
• Unilateral upper extremity lymphedema deteriorates the postural stability in breast cancer survivors
• Postural Stability in Patients with Lower Limb Lymphedema
• Disability, psychological distress and quality of life in breast cancer survivors with arm lymphedema

DISFIGUREMENT

• Adjusting to disfigurement: processes involved in dealing with being visibly different
• Quality of Life in Cancer Patients with Disfigurement due to Cancer and its Treatments
• Quality-of-life and body image impairments in patients with lymphedema
• Association of lower extremity lymphedema with pelvic floor functions, sleep quality, kinesiophobia, body image in patients with gynecological cancers

QUALITY OF LIFE

• The impact of lower limb chronic oedema on patients' quality of life
• Quality of life in patients with primary and secondary lymphedema in the community
• Evaluating the effect of upper-body morbidity on quality of life following breast cancer treatment.
• Functionality and quality of life of patients with unilateral lymphedema of a lower limb: a cross-sectional study
• The effect of complete decongestive therapy on the quality of life of patients with peripheral lymphedema

PSYCHOSOCIAL IMPACT

• Psychosocial Impact of Lymphedema.
• Associations between chronic disease, age and physical and mental health status
• A network analysis of psychological flexibility, coping, and stigma in dermatology patients
• 'Abandoned by medicine'? A qualitative study of women's experiences with lymphoedema secondary to cancer, and the implications for care
• People are neglected, not diseases.
• Chronic edema/lymphoedema: under-recognized and under‐treated.
• Lymphatic Medicine: Paradoxically and unnecessarily ignored.
• Medical education: a deficiency or a disgrace.

PEDIATRIC LYMPHEDEMA

• NORD: Rare Disease Database - Lymphedema
• Medical management of lymphedema.
• Primary lymphedema in childhood.
• An approach to familiar lymphedema
• Pediatric Children Lymphedema
• Primary Lymphedema French National Diagnosis and Care Protocol (PNDS).
• Lymphatic filariasis: an infection of childhood.
• Lymphatic filariasis in children: clinical features, infection burdens and future prospects for elimination.

LYMPHATIC FILARIASIS / PODOCONIOSIS

• Podoconiosis: Clinical spectrum and microscopic presentations.
• Podoconiosis: A Possible Cause of Lymphedema in Micronesia.
• A cross-sectional study to evaluate depression and quality of life among patients with lymphoedema due to podoconiosis, lymphatic filariasis, and leprosy.
• The impact of acute adenolymphangitis in podoconiosis on caregivers.
• Neglected tropical diseases and disability-what is the link?
• Locomotor disability in bancroftian filarial lymphoedema patients.
• Neglected patients with a neglected disease?
• Neglected tropical diseases and mental health: a perspective on comorbidity.
• People are neglected, not diseases.
• Addressing Inequity: Neglected Tropical Diseases and Human Rights.
• Neglected Tropical Diseases, Conflict, and the Right To Health.

BLOOD VASCULAR SYSTEM 

• Peripheral Edema
• Phlebolymphedema
• Understanding Chronic Venous Disease: A Critical Overview of Its Pathophysiology and Medical Management
• Role of the lymphatic vasculature in cardiovascular medicine
• Communication between lymphatic and venous systems
• Phlebopathies and occupation
• Phlebopathies and workers
• Evidence of health risks associated with prolonged standing at work and intervention effectiveness
• Leg edema formation and venous blood flow velocity during a simulated long-haul flight

Articles that may also interest you: 
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• FOCUS ON THE TERM ELEPHANTIASIS AND ITS IMPLICATIONS FOR LYMPHOEDEMA 

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• SPANISH LYMPHEDEMA ASSOCIATIONS – SPANISH NATIONAL FEDERATION OF LYMPHEDEMA ASSOCIATIONS

LYMPHEDEMA INCIDENCE 
AND PREVALENCE
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