[Acute inflammatory exacerbations in lymphoedema (author's transl)]

Area of Science:

• Dermatology
• Vascular Medicine
• Pathology

Context:

• Erysipelas, a common skin infection, can lead to severe cutaneous and lymphatic complications.
• Necrosing lymphangitis and gangrenous lymphangitis represent serious sequelae, particularly in the lower extremities.
• These complications can result in obliterating thrombolymphangitis, mimicking deep vein thrombosis.

Purpose:

• To describe the clinical, lymphographic, and histopathological changes associated with severe erysipelas complications.
• To detail the progression of lymphangitis and thrombolymphangitis.
• To highlight the diagnostic challenges and therapeutic considerations.

Summary:

• Cutaneous lesions, including necrosing lymphangitis, arise after acute erysipelas, especially in the calf.
• Obliterating thrombolymphangitis, a severe outcome, presents with symptoms similar to lower limb venous thrombosis.
• Lymphography reveals dynamic changes in lymphatic vessels, progressing to severe stasis in chronic phases.
• Histopathology shows acute inflammatory infiltrates evolving into fibrous changes, indicative of chronic lymphatic damage.

Impact:

• Understanding these severe erysipelas complications is crucial for accurate diagnosis and timely intervention.
• The study emphasizes the importance of lymphography in assessing lymphatic damage and disease progression.
• Findings guide therapeutic strategies, including endoarterial approaches, for managing complex lymphatic and vascular disturbances.