5 things every GP should know about lymphoedema

Lymphoedema is a chronic and permanent swelling which can affect any area of the body, most commonly affecting the limbs. It can impact on a person’s body image, self-esteem and cause not only physical, but emotional distress as well.
The list below is by no means a definitive or finite description of lymphoedema and is to be used as a guide only.

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1 Causes

Primary – Hereditary, Congenital
Secondary – Many Cancers and their treatments, Venous disease, Immobility, Injury, Filariasis

2 Treatment

Skin care – daily inspection,washing and moisturizing of skin.
Exercise and maintenance of mobility.
Compression garments / multi-layer lymphoedema bandage.
Simple / Manual Lymphatic Drainage
Referral to specialist clinic

3 Complications

Cellulitis
Lymphorrhoea
Skin changes
Skin folds
Social/Psychological impact – lowered self-esteem, difficulties at work, finding clothes etc

4 Risk Factors

Lymph node removal: irradiation increases the risk
Venepuncture or blood pressure on at risk or oedematous limb
Wounds

5 Medication

NONE – condition requires self management and specialist support
Diuretics only if patient has cardiac history
Antibiotics as per Consensus Document for Cellulitis
Pain control – need to identify cause of pain

This was first published by the by the British Lympholgy Society (BLS). There is a free BMJ learning module on lymphoedema available to healthcare professionals.

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