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

The author describes changes in the skin, lesions in the lymph vessels and changes seen on lymphography. Amongst cutaneous lesions, necrosing lymphangitis or gangrenous lymphangitis are the most serious. In the calf, they develop after an extensive episode of acute erysipelas. In erysipelas, the most common cutaneous lesion, the course varies according to associated disturbances, lymphatic and lymphnode. Combining of these lesions results in the most severe forms of obliterating thrombolymphangitis, capable of simulating venous thromboses of the lower limbs. In abscesses associated wtih severe erysipelas, massive eosinophilia found. Endoarterial therapy is invariably selected. Lymphographic appearances are dependent upon the stage of progression of inflammation. Disappearance, increase in vascular parietal permeability, varicose and ectasic appearance of the lymphatics may be seen in the superficial and deep collecting vessels. During the chronic phase, lesions are more extensive and more obvious. They are characteristic of severe lymphatic stasis. Histopathological studies show lymphangitis and perilymphangitis characterized by polynuclear neutrophil infiltration during the acute phase. At a more advanced stage, obliterating endolymphangitis and acute thrombolymphangitis are followed at the chronic phase by fibrous lymphangitis.