ABSTRACT
This chapter discusses the classification of lymphedema in terms of the Clinical, Etiology, Anatomy, and Pathophysiology categories. A logical extension is to consider using it to classify lymphedema and lymphatic disorders. The purpose of the lymphatic system is to remove interstitial fluid from the periphery and return it to the circulation. In the early stages of lymphedema, the swelling may be occult, although objective testing might reveal subclinical abnormalities involving the lymph vessels. Lymphedema can often be appreciated by eliciting the “Stemmer sign,” which involves the inability to pinch the skin at the base of lymphedematous toes. Limbs affected by lymphedema are susceptible to episodes of cellulitis or lymphangitis, usually caused by Gram-positive cocci such as Streptococcus. Lymphedema can produce a variety of other symptoms, and these should be sought and documented as part of the clinical evaluation.
