Puffy Foot Syndrome: An Important Often Overlooked Clinical Entity

The puffy foot syndrome, a novel clinical entity, describes the complication of secondary lymphedema with chronic progression in the feet, a finding that has often been overlooked in the non-tropical setting. While previously well described in the upper extremities, this complication has not been fully explored in the lower extremities. However, given increasing rates of diabetes mellitus, obesity, and a myriad of other possible etiologies in the United States, it is important to understand this entity and its non-viral, non-parasitic causes in non-tropical regions. This review delineates common illustrative properties of this syndrome observed in clinical practice as well as long-term complications, including Ruocco's immunocompromised cutaneous district, that are often overlooked. Furthermore, a novel method of staging is suggested for this condition, reflective of increasing risk of complication, infection, and malignancy. We also highlight the increased need for improved detection and recognition of this condition to avoid possibly deleterious outcomes.