Lymphedema has 4 stages which we will discuss in this article. To recap, Lymphedema is a condition where the amount of lymphatic fluid is not effectively and/or efficiently moved out of the body because of various conditions such as radiation, chemotherapy, trauma, venous insufficiency, infection, or malformation of lymphatic vessels, which is the case in Primary lymphedema. Lymphedema can occur to any part of the body and at any age.
There are various degrees of lymphedema, from mild to extreme swelling, which can cause long lasting life threatening deficits, such as deformities and recurring infections. In order to differentiate the progressive changes Lymphedema causes to various body parts. The International Society of Lymphology has established a staging system to identify the progression, or severity, of the disease. These stages are as follows:
Stage 0 Lymphedema
Is also known as Latency or Pre-clinical Stage. At this stage a person is at risk of developing Lymphedema. However, no swelling or other visible evidence of Lymphedema is present. A person may verbalize heaviness, discomfort, or fullness in the affected area(s). This stage may take weeks, months, or even years before serious signs may appear.
Stage 1 Lymphedema
At this stage a person may start seeing an accumulation of fluid in the affected area. There is visible swelling that is temporarily reduced by elevation. The swollen tissues are soft and a pressure mark may be left when pressing on the area.
Stage 2 Lymphedema
At this stage the swelling in the area increases and does not reduce with elevation. Changes in tissue may also be evident. These changes may be: hardness of tissue. When pressing on skin, a very small indentation may occur if any at all. An increased risk for infection is present.
Stage 3 Lymphedema
It is also known as Lymphostatic Elephantiasis. At this stage the affected area(s) becomes extremely thickened, swollen, and firm because of a blockage in the flow of lymph fluid and a buildup of fluid in the affected tissue. The skin becomes extremely hardened and pressure does not produce an indentation of the skin. Elasticity of the skin is lost. Skin changes color, usually a dark red color, also known as Hemosiderin Staining. Papillomas (benign tumor-like formations), Hyperkeratosis (increase thickness in the outer layer of the skin), etc may be present in affected area(s). The increased risk for infection of the skin, fungal infections, deformity and decreased mobility are much greater at this stage.
When we meet patients we evaluate them to determine what stage they are at and determine a treatment plan moving forward. In Stages 0 and 1, fitting of a flat knit compression garment is recommended to slow down the progression of lymphedema. Stages 2 and 3, will require intense therapy to reduce swelling and improve the skin condition of the affected area(s) followed by flat knit custom compression garments to contain the affected area(s).
If you or a loved one has been diagnosed with lymphedema and are looking for Lymphedema treatment feel free to contact us.