What are the stages of lymphedema?

Stage 0 – latent lymphedema

  • the lymph vessels are damaged, but no swellings are visible yet, normal lymph drainage
  • no edema exists (yet)

Stage 1 – spontaneously reversible lymphedema

Swellings occur during the course of the day, which are completely or partially reduced when the patient is elevated. When pressure is applied to the tissue, a dent is formed which remains for some time.

  • impaired lymph drainage
  • edema occurs during the course of the day
  • reduction of the edema after lying with the legs elevated
  • visible dent after strongly pressing with the finger

Stage 2 – not spontaneously reversible lymphedema

The swellings remain even during longer rest periods. The skin is hardened and raising the arms or legs does not bring any relief. Dents are difficult or impossible to push in.

  • hardened oedema
  • no reduction of the oedema after lying with the legs elevated
  • difficult or impossible to press the skin indentation inwards

Stage 3 – Elephantiasis

There is swelling with skin changes (e.g. small blisters from which lymph fluid leaks). In the past, this more pronounced form of such swellings was also called “elephantiasis”.

  • bulky swelling with extreme proportions (formation of beads)
  • hardened skin
  • creation of bubbles and fistulas from which lymph can trickle
  • complications: Erysipelas; deep wounds which do not easily heal

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