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Prevalence of Pre-Existing Subclinical Leg Lymphedema in Patients with Erysipelas

Eva Klara Merzel Šabović1,2, Tanja Planinšek Ručigaj1

  • 1Dermatovenerology Clinic, University Medical Centre Ljubljana, Ljubljana, Slovenia.

Journal of Cutaneous Medicine and Surgery
|June 21, 2025
PubMed
Abstract

Insights

Subclinical lymphedema is common in patients with erysipelas, often occurring bilaterally. This condition frequently triggers erysipelas and increases recurrence risk, suggesting compression therapy for prevention.

Area of Science:

  • Dermatology
  • Infectious Diseases
  • Vascular Medicine

Background:

  • Erysipelas is a common bacterial skin infection with often unknown triggers.
  • Pre-existing subclinical lymphedema is suspected as a potential trigger for erysipelas.
  • Understanding triggers is crucial for managing recurrent infections.

Purpose of the Study:

  • To determine the prevalence of subclinical lymphedema in the unaffected leg of erysipelas patients.
  • To investigate the relationship between subclinical lymphedema and erysipelas episodes.
  • To assess the potential role of subclinical lymphedema as a primary trigger and risk factor for erysipelas.

Main Methods:

  • Prospective study of 106 consecutive patients 3-6 months post-erysipelas.
  • Lymphoscintigraphy performed on both legs using Tc-99m-labelled human albumin.
  • Analysis of subclinical lymphedema prevalence across demographics and risk factors.

Main Results:

  • Subclinical lymphedema found in 82% of patients on the unaffected leg.
  • Prevalence was consistent across genders, age groups, and erysipelas risk factors.
  • Lymphedema prevalence increased with erysipelas episodes (74% for one, 100% for three+).

Conclusions:

  • High prevalence of bilateral subclinical lymphedema in erysipelas patients.
  • Subclinical lymphedema frequently triggers erysipelas and increases recurrence risk.
  • Recommends bilateral leg compression therapy to prevent erysipelas recurrence and lymphedema exacerbation.
Keywords:
cellulitiserysipelaslymphatic systemlymphoscintigraphysubclinical lymphedema

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