[Lymphedema of the extremities: a missed vascular pathology?]

The diagnosis and treatment of lymphedemas of the extremities, although relatively common in the western countries, mainly in the area of oncology, are scarcely mentioned in the international literature and in Portugal very little work has been devoted to this area. Nevertheless, they may cause severe functional and aesthetic disability, the main reason why decided to reassess its pathology, with an emphasis on the clinical diagnosis and medical therapy. We stress the importance of oedema of the instep the value of the Stemmer's sign in the diagnosis, and the complete decongestive physiotherapy in the management. When associated to the pharmacological therapy and the correct use of elastic stockings, the control of most of the cases can be achieved. Surgical therapy is reserved for rare cases and should be regarded as an adjuvant to intensive medical therapy, which should accompany the patient throughout life time.