Department of Skincare Science, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
Research Center for Implementation Nursing Science Initiative, School of Health Sciences, Fujita Health University, Aich, Japan.
Lymphat Res Biol. 2022 Aug;20(4):376-381. doi: 10.1089/lrb.2021.0004. Epub 2021 Nov 11.
Recurrent cellulitis has high impact on physical, psychological, and social aspects for lymphedema patients. We speculated that identification of characteristics of skin and subcutaneous adipose tissue with cellulitis history can help considering new approach for prevention of recurrent cellulitis in lymphedema patients. Therefore, in this study, we aimed to noninvasively identify the ultrasonographic features of skin and subcutaneous tissue of lymphedema in patients with a cellulitis history. This was a cross-sectional study, and all data were collected from patients' medical records. We assessed ultrasonographic images of the lower extremity of patients with lymphedema that were obtained in a lymphedema clinic. The ultrasonographic images were analyzed on the basis of the following five features: dermal hypoechogenicity, unclear dermal border, unclear superficial fascia, increased subcutaneous echogenicity, and subcutaneous cobblestone appearance. Fifty-two ultrasonographic images from 19 female patients with lower extremity lymphedema, including 8 with and 11 without a cellulitis history, were analyzed. The proportion of dermal hypoechogenicity on the upper leg was significantly higher in the patients with than in those without a cellulitis history (75.0% vs. 9.1%, = 0.006). Cellulitis history in lymphedema patients appears to be associated with dermal hypoechogenicity, particularly in the proximal lower extremity. This finding suggests that it may be the initial step to consider new approach for prevention of recurrent cellulitis in lymphedema patients.
复发性蜂窝织炎对淋巴水肿患者的身体、心理和社会方面都有很大的影响。我们推测，识别有蜂窝织炎病史的皮肤和皮下脂肪组织的特征可以帮助我们考虑预防淋巴水肿患者复发性蜂窝织炎的新方法。因此，在这项研究中，我们旨在非侵入性地识别有蜂窝织炎病史的淋巴水肿患者皮肤和皮下组织的超声特征。这是一项横断面研究，所有数据均来自患者的病历。我们评估了淋巴水肿诊所获得的淋巴水肿患者下肢的超声图像。根据以下五个特征分析超声图像：皮肤低回声、皮肤边界不清、浅筋膜不清、皮下回声增强和皮下鹅卵石样外观。分析了 19 名女性下肢淋巴水肿患者的 52 个超声图像，其中 8 名有蜂窝织炎病史，11 名无蜂窝织炎病史。有蜂窝织炎病史的患者大腿皮肤低回声的比例明显高于无蜂窝织炎病史的患者（75.0% vs. 9.1%，=0.006）。淋巴水肿患者的蜂窝织炎病史与皮肤低回声有关，尤其是在下肢近端。这一发现表明，这可能是考虑预防淋巴水肿患者复发性蜂窝织炎的新方法的初始步骤。
