Agharbi Fatima-Zahra
Centre Hospitalier Régional Tétouan, Tétouan, Maroc.
Pan Afr Med J. 2018 Dec 28;31:251. doi: 10.11604/pamj.2018.31.251.16166. eCollection 2018.
Limb lymphedemas are due to a malfunction of the lymphatic system responsible for lymph stasis in the interstitial tissue and secondarily to an increase in the volume of the affected limb. They are divided into primary lymphedema (PL) and secondary lymphedema (SL). SLs develop most frequently in lower limbs after breast cancer treatment while lymphedemas are either secondary (iatrogenic or infectious) or primitive, most often sporadic, sometimes familial or they can be part of syndromes resulting in malformations and/or more complex genetics in upper limbs. The diagnosis of lymphedema is essentially based on clinical examination. Erysipelas are the main complication of lymphedema. Other abnormalities are often visible: yellowish skin and nails, lymphangiectasias, keratotic papules with papillomatosis, lichenified plaques. The main differential diagnosis in patients with limb lymphedema is lipoedema, defined as body fat distribution from the hips up to the ankles and affecting almost exclusively obese women. We report the case of a 30 year old man with left lower limb lymphedema occurred at puberty complicated by verrucous papillomatosis. It is a late-revelation congenital lymphedema.
肢体淋巴水肿是由于淋巴系统功能障碍导致间质组织淋巴淤滞,继而引起患侧肢体体积增大。淋巴水肿分为原发性淋巴水肿(PL)和继发性淋巴水肿(SL)。继发性淋巴水肿最常见于乳腺癌治疗后的下肢,而淋巴水肿要么是继发性的(医源性或感染性),要么是原发性的,多数为散发性,有时为家族性,或者可能是导致上肢畸形和/或更复杂遗传学综合征的一部分。淋巴水肿的诊断主要基于临床检查。丹毒是淋巴水肿的主要并发症。其他异常也常常可见:皮肤和指甲发黄、淋巴管扩张、伴有乳头瘤病的角化丘疹、苔藓化斑块。肢体淋巴水肿患者的主要鉴别诊断是脂肪性水肿,其定义为从臀部到脚踝的身体脂肪分布,几乎仅影响肥胖女性。我们报告一例30岁男性患者,青春期出现左下肢淋巴水肿,并伴有疣状乳头瘤病。这是一例迟发性先天性淋巴水肿。