What are the other causes of swelling?

Before the diagnosis of lymphoedema is made, the other many causes of swelling (oedema) must be excluded. These include cardiac oedema, low blood protein, kidney oedema, allergic oedema and hereditary angioedema (a particular inherited intermittent swelling). Another important cause of swelling is an abnormality of the veins. In lipodystrophy, there is an abnormality of subcutaneous fat deposition and this is frequently misdiagnosed as lymphoedema. In some cases it is important to make sure that the swelling is not a result of a tumour or mass obstructing the lymphatics. In other cases the swelling occurs when a limb is not being used normally. Occasionally, there is a congenital abnormality of blood vessels, veins or arteries, in the affected limb.

Can lymphoedema come on suddenly?

In most cases the onset of lymphoedema is insidious but the onset can be sudden. Many patients say that they had very mild or no swelling initially but that some trauma, such as a twisted ankle, minor infection or insect bite, precipitated a rapid progression of the lymphoedema.

What are the complications of lymphoedema?

Because the tissue fluid is not being cleared normally, any bacteria which get into the skin or subcutaneous tissues from a minor trauma or scratch are more likely to cause an infection. The infection which results is called cellulitis. It is unfortunate that with each episode of cellulitis lymphatic vessels are damaged further. Avoidance of infections is therefore important.
Very rarely after many years of lymphoedema, a malignant tumour of the lymph vessels can occur.