Phlebolymphedema-a common underdiagnosed and undertreated problem in the wound care clinic

Abstract

This article focuses on the pathophysiology of phlebolymphedema, as well as proper diagnosis and treatment. It is hoped that this article will improve care of patients in wound care clinics and motivate wound care physicians to consider adding care of lymphedema patients to their clinical practice.

Keywords: Chronic venous insufficiency; Edema; Lymphedema; Phlebolymphedema.

Figure 1

Classic Champagne Bottle Change of Phlebolymphedema (Chronic Venous Insufficiency With Secondary Lymphedema Development and Lipodermatosclerosis).

Figure 2

Kaposi-Stemmer Sign: Inability to Tent Skin Between Fingers Is Diagnostic of Lymphedema.

Figure 3

Phlebolymphedema Patient With Venous Ulceration With Associated Lipodermatosclerosis of Periwound Area. Note Slight Sausage Toe Changes and Dorsal Foot Swelling That Are Characteristic of Lymphedema.

Figure 4

Severe Elephantiasis of Chronic Lymphedema With Papillomatosis, Lipodermatosclerosis, and Fibrosis of Dermal Skin.

Figure 5

A, Phlebolymphedema Patient With Extensive Nodular Fibrosis Changes of Advanced Lipodermatosclerosis. B, Close-up of Patient of Figure 5A: Phlebolymphedema With Extensive Nodular Fibrosis Changes of Advanced Lipodermatosclerosis.

Figure 6

A, Demonstration of Lymphedema Rubra in Patient With Phlebolymphedema. B, Demonstration of Lymphedema Rubra in Patient With Phlebolymphedema: Photo Taken Directly After Finger Release.