Lymphedema may arise in the lower extremities following injury to the lymphatic drainage. Filariasis is a common cause in the tropics that can progress to elephantiasis. A seven stage severity scale can aid in the monitoring of patients over time.
Parameters:
(1) leg swelling
(2) shallow skin folds
(3) deep skin folds (the base can only be seen when the edges are actively separated by hand)
(4) knobs (includes keloidal scars)
(5) mossy lesions (fluid filled growths in the skin, translucent to light)
(6) disability
|
Parameters |
Stage 1 |
Stage 2 |
Stage 3 |
Stage 4 |
|
leg swelling |
goes away without treatment |
stays without treatment |
permanent |
permanent |
|
skin folds |
none |
none |
shallow |
shallow folds may be present |
|
knobs |
none |
none |
none |
present |
|
mossy lesions |
none |
none |
none |
none |
|
disability |
none |
minimal |
mild |
mild to moderate |
|
Parameters |
Stage 5 |
Stage 6 |
Stage 7 |
|
leg swelling |
permanent; may extend above the knee |
permanent, may be mild or severe |
permanent, usually extends above the knee |
|
skin folds |
deep with or without shallow folds |
deep and/or shallow |
deep and/or shallow |
|
knobs |
present |
present or absent |
present or absent |
|
mossy lesions |
none |
present |
present or absent |
|
disability |
moderate |
moderate |
severe |
|
Stage |
Defining Characteristic |
|
1 |
goes away without treatment |
|
2 |
stays without treatment |
|
3 |
shallow skin folds |
|
4 |
knobs |
|
5 |
deep skin folds |
|
6 |
mossy lesions |
|
7 |
severe disability |
