ABSTRACT
The increased incidence of infection in lymphedematous tissue is a well-known clinical entity. The initial lymphatics and collecting trunks in the area of inflammation undergo major changes. Localization in the lymphatic trunks between initial lymphatics and the first node explains the rapid appearance of lymphatic streaks in bacterial infection. Inflammatory changes of the erysipelas type in the skin of lower limbs develop after trauma, thrombophlebitis, in varicose ulcer, interdigital infections with erosions, and during bacterial infections at remote sites of the body. Erysipelas may not necessarily be recognized as the primary cause of lymphedema. In contrast, the preexisting changes in lymphatics may facilitate development of erysipelas and lymphangitis. Methods of sampling of skin microflora include: impression, as agar applied to skin or stickly backed cellophane tape, and sterile velvet pads; washing with sterile cottonwool swabs and scrubbing, which disperse the aggregates of bacteria; and biopsy, which can demonstrate location of the organisms on the skin.
