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Lymphedema is a consequence of prolonged edema; edema is an interference of the physiologic movement of fluid from capillaries through the interstitial spaces and back into lymphatics. Dysfunction of the lymphatic system because of genetic or congenital defects or related to infection, surgery, or external trauma leads to functional impairment of the tissue clearing ability and progression to clinical signs of lymphedema. In all the clinical disorders discussed, edema may be transient and pitting with pressure but, with time, becomes fixed and accompanied by dermal sclerosis and epidermal hyperplasia. Type I lymphedema, an autosomal dominant disease characteristically has a mutation in VEGFR3 (also called the FLT4 gene). Lymphedema is almost always from birth and is confined to the legs with deep creases over the toes and small deformed (“ski jump”) toenails and is characterized hypoproteinemia from intestinal loss of albumen, chylous ascites, and scrotal edema. Lymphangiography demonstrates dysplastic lymphatics in both clinically affected and clinically normal extremities, emphasizing the complexity of the pathophysiology, leading ultimately to disease.
The fork-head family transcription factor defects have in common mutations in a transcription factor, the fork-head transcription factor, FoxC2 [MFH1 (mesenchyme forkhead-1); fork-head is the name of a Drosophila trait].
Edema develops around puberty, later than type I disease, and facial puffiness with deep creases and wrinkling may occur.
Worldwide lymphedema due to filariasis is estimated to affect between 90 and 100 million individuals . Other infectious diseases with lymphedema are much less common and include lymphogranuloma venereum with elephantiasis of the penis and scrotum, granuloma inguinale , and tuberculosis . There are two major etiologies to non-hereditary lymphedema on a worldwide basis—venous disease of the legs (discussed earlier in this chapter) and postcancer, especially carcinoma of the breast-related lymphedema. Unilateral lymphedema suggests localized obstructing factors, but bilateral lymphedema can be due to obstruction in the pelvis or abdomen. Inflammation with redness, pain, and swelling is not lymphedema but can be pyogenic infection, most commonly with S. Prolonged lymphedema leads to fibrosis and epidermal hyperplasia with verrucous hyperkeratosis (Fig. Diuretics may worsen the condition and should not be used as a primary treatment for lymphedema. Microsurgery of lymphatics to bypass obstructed nodes can be considered if nonsurgical treatments are not successful. Excisional or suction-assisted lipectomy (liposuction) may be an option in selected patients.


Any patient with lymphedema, whatever the cause, should keep their feet dry, nails trimmed, and prevent and aggressively treat pyogenic infection. Lymphedema is common in some locations, face and penis especially; low-grade infection is usually invoked as the cause. In puffy hand syndrome, intravenous drug use with injections into hands or feet is associated with lymphedema.
It can be caused due to allergic reactions by changing eyelid polishes or other cosmetics like hair spray or makeup. Blepharitis is a condition of eyelid inflammation which causes redness and irritation on the eyes. This is caused due to bacteria or virus and sometimes due to potential allergens like dust, smoke. When the oil glands of the eyes are blocked for some reason, it may cause swelling of eyelids with redness and itchiness. Most of the causes of swollen eyelids are not that serious to rush for treatment, but you can consult your doctor if swelling does not subside within a day or two. When the eyelids become swollen there may be symptoms of eye irritation, redness and watery eyes. Always remove contact lenses before you put eye-drops or any other home remedy on your eyes. In edema, the equilibrium is shifted and more fluid remains in the interstitial space—when this becomes chronic, inflammatory cells and their cytokines lead to an irreversible state. Lymphedema praecox (Latin for premature) should not be used for this disease as it only leads to further nosologic confusion. The microfilaria invade lymphatics, reproduce within the lymphatics, and damage local lymphatics and regional nodes, often resulting in hydroceles and scrotal swelling, classic components of filarial elephantiasis. Although the limb swells during the day, indentations from socks can be seen on the leg at nighttime, returning toward normal during the night, but the leg stays swollen, and initially concerns may be cosmetic in nature.
Your will have burning sensation or gritting feeling on the eyes when infected with blepharitis. Even changing your contact lenses and eye drops can cause conjunctivitis leading to redness and swelling of eyelids. When the subcutaneous glands or tissues get inflamed (cellulitis) it may cause eye irritation and eyelid swelling.


Excess of water may be discharged from the eyes and because of this you may have trouble vision. The concept of type II lymphedema can be enlarged to include four syndromes with similar molecular defects: Lymphedema-late onset (Meige syndrome), lymphedema-distichiasis syndrome, lymphedema and ptosis syndrome, and the hereditary forms of lymphedema with the yellow nail syndrome. In patients with primary and secondary lymphedema in the absence of venous or arterial disease, manual lymphatic drainage and sequential pneumatic pumps, in addition to compression wraps and garments, may be useful. You can always apply warm compression for reducing the inflammation or take antihistamines.
Some people will feel as though sand is deposited inside the eyes during this situation which will cause swelling of eyelids. Stye is an eye infection caused by bacteria on the sebaceous glands forming cysts inside the eyes.
You will be prescribed lubricating medicines that will produce tears from your eyes to reduce pain and inflammation.
Don’t forget to remove your makeup before you go to sleep since certain chemicals present in the eyelid cosmetic can cause irritation and swelling. Late on-set-type II disease has decreased or absent axillary nodes and decreased lymphatics above the inguinal ligament on scintilymphangiography. A common complication is contact dermatitis from the use of topical antibiotics or multiple emollients and anti-inflammatory creams. Lymphangiosarcoma, the Stewart-Treaves syndrome when associated with postmastectomy lymphedema, is the common lesion in chronically lymphedematous locations . If the eyes are left with allergen, automatic defense system of the eyes secretes histamines for protecting it which would make the eyelids to swell. In case of infection or allergy you can consult your eye doctor to get prescription eye-drops to kill bacteria or virus.
Kaposi-Stemmer sign, a feature of chronic lymphedema, describes the skin over the proximal digit of the second toe that cannot be elevated; in edema the skin can be elevated.



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