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Cinar E, Ata BN, Eyigor S. Primary lymphedema of childhood: Treatment results from a tertiary center. Arch Pediatr 2024; 31:245-249. [PMID: 38637245 DOI: 10.1016/j.arcped.2024.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 12/05/2023] [Accepted: 02/11/2024] [Indexed: 04/20/2024]
Abstract
BACKGROUND Primary lymphedema is the most common form of lymphedema presenting in the pediatric age group. Childhood lymphedema is caused by hereditary or congenital malformations in the lymphatic system that can manifest at birth or during childhood or adolescence. OBJECTIVES Complex decongestive therapy (CDT) is the cornerstone of conservative management of lymphedema in both adult and pediatric lymphedema patients, although pediatric treatment guidelines are still lacking. In this study we aimed to assess the effects of CDT on pediatric patients. METHODS Childhood lymphedema patients who presented to the lymphedema rehabilitation unit of our university hospital before the age of 18 and who were treated for lymphedema with CDT were included in the study. Data on patient demographics, disease characteristics, and treatment duration were recorded. Limb volumes were calculated from patient measurements using a spreadsheet software (Limb Volume Calculator) that utilized the geometric formula for volume of a truncated cone. Measurements were taken before treatment and also weekly after initiation of treatment. Percent excess volume (PEV) was used instead of absolute volume difference to define the severity of lymphedema. RESULTS A total of 34 limbs from 24 patients were included in the study. The mean age of the patients was 10.1 ± 4.9 years and 14 (58.3 %) were female. Most patients had one affected limb but 16 had bilateral lower-extremity lymphedema. The mean duration of treatment with CDT was 153.6 ± 155.8 days. Excess volume percentage change between pre-treatment PEV (602.8 ± 713.8) and post-treatment PEV (514.6 ± 699.1) was found to be statistically significant (p < 0.05). CONCLUSION Pediatric lymphedema management is a difficult and less well studied area in lymphedema rehabilitation. Our data support the use of CDT, which is a safe and effective treatment method, for pediatric lymphedema patients.
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Affiliation(s)
- Ece Cinar
- Ege University School of Medicine, Department of Physical Medicine and Rehabilitation, Turkey.
| | - Benil Nesli Ata
- Bakircay University Cigli Regional Training Hospital, Department of Physical Medicine and Rehabilitation, Turkey
| | - Sibel Eyigor
- Ege University School of Medicine, Department of Physical Medicine and Rehabilitation, Turkey
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2
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Jha CK, Sinha U, Sinha M, Singh PK. Breast carcinoma presenting with upper limb lymphedema - A rare case. Breast Dis 2023; 42:395-399. [PMID: 38108339 DOI: 10.3233/bd-230022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2023]
Abstract
Lymphedema (LE) in a breast cancer patient usually results from axillary lymph node dissection, sentinel lymph node biopsy, and/or axillary radiotherapy. Although lymphatic obstruction and consequent LE can occur due to axillary lymph node involvement, such presentation in breast cancer patients has rarely been reported. This report describes the case of a 50-year-old lady with right breast carcinoma who presented with right upper limb lymphedema. Surprisingly, she did not have any bulky axillary lymphadenopathy that could have accounted for lymphedema of the upper limb, but a suspicious breast mass was present on clinical examination. Diagnosis of breast cancer on clinical examination can be challenging in such patients due to breast edema and careful imaging of the breast and axilla with appropriate imaging tools (mammogram, ultrasound, MRI, PET mammography) should be resorted to before excluding malignancy. Lymphoscintigraphy confirmed the findings of lymphedema in the right upper limb and revealed uptake in the epitrochlear lymph nodes of the contralateral limb suggesting that she might had pre-existing widespread "subclinical lymphedema" which presented as "clinical lymphedema" in right upper limb after axillary lymph node/lymphatic involvement by right breast carcinoma.
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Affiliation(s)
- Chandan Kumar Jha
- Department of General Surgery, All India Institute of Medical Sciences, Patna, India
| | - Upasna Sinha
- Department of Radiodiagnosis, All India Institute of Medical Sciences, Patna, India
| | - Mainak Sinha
- Department of General Surgery, All India Institute of Medical Sciences, Patna, India
| | - Prashant Kumar Singh
- Department of General Surgery, All India Institute of Medical Sciences, Patna, India
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Beauty is not perfection: what Leonardo’s Lady with an Ermine can suggest to aesthetic surgery. EUROPEAN JOURNAL OF PLASTIC SURGERY 2020. [DOI: 10.1007/s00238-020-01713-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
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4
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Liu N, Gao M, Yu Z. Dysfunction of dermal initial lymphatics of the arm and upper body quadrant causes congenital arm lymphedema. J Vasc Surg Venous Lymphat Disord 2020; 9:482-488. [PMID: 32599305 DOI: 10.1016/j.jvsv.2020.06.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Accepted: 06/05/2020] [Indexed: 11/19/2022]
Abstract
OBJECTIVE The objective of this study was to explore the pathologic process underlying primary lymphedema. METHODS Twenty-seven patients with unilateral congenital arm lymphedema who visited our clinic from January 1, 2014, to May 30, 2019, were enrolled. The patients' clinical signs and the findings of indocyanine green (ICG) lymphography, skin tissue immunohistochemical staining, and whole exome sequencing of tissue and blood were evaluated. RESULTS Among the 27 patients, 11 were diagnosed with stage II and 16 were diagnosed with stage III lymphedema. No lymphatic vessels were visualized in the affected arm in 25 of 27 (93%) patients who underwent ICG lymphography; likewise, no lymphatics were found in the territories of axillary lymph node drainage in the trunk, irrespective of any anomalies of the axillary lymph nodes. In only two (7%) patients, an unclear lymphatic trunk gradually appeared in the dorsum of the affected hand. The number of initial lymphatics was increased in the skin specimens of all nine patients in whom lymphatics were not demonstrated by ICG lymphography. Among 14 tested patients, we found compound heterozygote variants in the PIEZO1 gene in only one (7%) patient. Two missense variants, c.4072C>T; p.Arg1358Cys and c.5033C>T; p. Ala1678Val, were identified and found to have been inherited from the father and mother, respectively. No other pathogenic or likely pathogenic variants of currently known lymphedema-related genes were identified in the remaining 13 patients. No genetic difference was found between the lymphedematous and nonedematous healthy skin tissue of the same person. CONCLUSIONS Segmental or regional dysfunction of the dermal initial lymphatics causes congenital arm lymphedema and may have implications for clinical treatment.
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Affiliation(s)
- Ningfei Liu
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
| | - Minzhe Gao
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Ziyou Yu
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Vignes S, Simon L, Benoughidane B, Simon M, Fourgeaud C. Clinical and Scintigraphic Predictors of Primary Lower Limb Lymphedema-Volume Reduction During Complete Decongestive Physical Therapy. Phys Ther 2020; 100:766-772. [PMID: 31944248 DOI: 10.1093/ptj/pzaa012] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Revised: 06/27/2019] [Accepted: 11/18/2019] [Indexed: 11/12/2022]
Abstract
BACKGROUND Primary lower limb lymphedema is a chronic debilitating disorder without curative treatment. The initial treatment phase is dedicated to reducing lymphedema volume, whereas the second aims to stabilize that volume. OBJECTIVE The objective of this study was to analyze clinical and lymphoscintigraphic characteristics during complete decongestive physical therapy as predictors of primary unilateral lower limb lymphedema-volume reduction. DESIGN This observational, retrospective study included 222 consecutive patients (January 2009-January 2017; median age: 45.8 years) with lymphedema affecting the entire lower limb, who received complete decongestive physical therapy for the first time in a specialized lymphedema management center. METHODS Complete decongestive physical therapy consisted of low-stretch bandaging, manual lymph drainage, exercises, and skin care for all patients. Lymphoscintigraphy preceded treatment. RESULTS Median lymphedema evolution was 73 months, and median excess volume was 34%. Median (interquartile range) lymphedema volumes were 2845 (1038-3487) mL before and 1276 (601-2195) mL after a median of 11 days of complete decongestive physical therapy, with 34% median reduction. Multivariate analyses retained age, body mass index >40 kg/m2, and previous cellulitis, as independently associated with lymphedema volume reduction. For each additional year of age, volume reduction increased 0.16%. Unexpectedly, log-transformed initial lymphedema volumes indicated a negative impact, that is, 4.95%, for each log-unit gain. Patients with previous cellulitis episode(s) obtained 6.9% and those with BMI >40 kg/m2 17.1% higher lymphedema volume reductions. Lower limb lymphoscintigraphy was available for 150 (67.6%) patients. Having dermal back flow was associated with greater lymphedema volume reduction than not (respectively, 39% vs 31%). LIMITATIONS This study was retrospective, and only 67.6% of patients underwent lymphoscintigraphy. CONCLUSION Our analysis identified clinical and scintigraphic predictors of primary lymphedema volume reduction for patients with unilateral disease. Lymphoscintigraphy helps confirm lymphedema and predict volume reduction. Further study is required to confirm these observations.
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Affiliation(s)
- Stéphane Vignes
- Department of Lymphology, Hôpital Cognacq-Jay, 15, rue Eugène-Millon, 75015 Paris, France
| | - Laura Simon
- Department of Lymphology, Hôpital Cognacq-Jay
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Moffatt C, Aubeeluck A, Stasi E, Mestre S, Rowan S, Murray S, Quere I. A Study Using Visual Art Methods to Explore the Perceptions and Barriers of Self-Management in Children and Adolescents with Lymphedema. Lymphat Res Biol 2020; 17:231-244. [PMID: 30995180 PMCID: PMC6636672 DOI: 10.1089/lrb.2018.0075] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
Background: The aims of this study were to explore, using visual art methodology, how children and adolescents perceive their lymphedema and conceptualize the barriers and enablers in self-management and to explore the role of an educational camp in promoting self-efficacy. Methods: Participants (speaking English, French, and Italian) were recruited during an educational camp for children with lymphedema. Children and adolescents used different methodologies to depict living and self-managing their condition. Younger children (aged 5–12 years) drew pictures, and all children and adolescents (aged 5–18 years) were given cameras and asked to take photographs that depicted their experience of learning self-management of their condition during the camp. Rose's critical visual methodology framework was used for analysis. Results: Analysis of the data produced five categories: Normal versus altered childhood, living with lymphedema; perceptions of lymphedema and self-care in younger children; adolescents' perception of living and managing lymphedema; learning self-efficacy; and insights into cultural differences in self-care. Conclusions: The study has shown that self-management is complex. Children and adolescents face many daily challenges and frustrations in managing their condition in addition to the normal challenges of development and growth that impact on: home life, time with friends, school activities, and relationships. Children expressed a deep longing for cure and a recognition that their lives were altered by having the condition that led to limitations in sport and wearing fashionable clothes and shoes. The importance of relationships with professionals was critical as was the experience of meeting and learning with other children through the camp experience. Attempts to simplify self-management techniques would appear to be a key priority as would a greater understanding of the self-beliefs young people have of their ability to influence and control their condition and its impact on their life.
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Affiliation(s)
- Christine Moffatt
- 1 School of Social Sciences, Nottingham Trent University, Nottingham, United Kingdom.,2 Department of Vascular Medicine, EA2992, CHU Saint Eloi, University of Montpellier, Montpellier, France
| | - Aimee Aubeeluck
- 3 School of Health Science and Medicine, University of Nottingham, Nottingham, United Kingdom
| | - Elodie Stasi
- 4 Center of Research of Immunopathology and Rare Diseases-Coordinating Center of the Network for Rare Diseases of Piedmont and Aosta Valley, Turin, Italy
| | - Sandrine Mestre
- 2 Department of Vascular Medicine, EA2992, CHU Saint Eloi, University of Montpellier, Montpellier, France
| | | | - Susie Murray
- 6 Centre for Research and Implementation of Clinical Practice, London, United Kingdom
| | - Isabelle Quere
- 2 Department of Vascular Medicine, EA2992, CHU Saint Eloi, University of Montpellier, Montpellier, France
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Cousins E, Cintolesi V, Vass L, Stanton AWB, Irwin A, Heenan SD, Mortimer PS. A Case-Control Study of the Lymphatic Phenotype of Yellow Nail Syndrome. Lymphat Res Biol 2019; 16:340-346. [PMID: 30130162 DOI: 10.1089/lrb.2018.0009] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Yellow nail syndrome (YNS) is a rare disease manifesting as a triad of yellow-green dystrophic nails, lymphedema, and chronic respiratory disease. The etiology of YNS is obscure and investigations are few. A single lymphatic pathogenesis has been proposed to account for all the associated features, and despite the lack of evidence for a unifying lymphatic mechanism, this hypothesis prevails. The objective was to explore the lymphatic phenotype in YNS and to establish whether lymphatic dysfunction could be a major contributing factor to the disease process. METHODS AND RESULTS Four-limb lymphoscintigraphy was performed on patients with YNS and on healthy, age-matched controls. All 17 patients had lower limb swelling, and 14 (82%) had upper limb swelling also, including 5 (29%) with hand involvement. None of the YNS lymph scans was completely normal. Combined qualitative and quantitative assessment showed that 67% of YNS scans were clearly abnormal compared with 36% of healthy control scans. Mean axillary and ilio-inguinal nodal tracer uptakes were 41%-44% lower in the YNS group than in the controls (p < 0.0001). CONCLUSIONS YNS is a lymphatic phenotype because lymphatic insufficiency was found to exist in all patients and the insufficiency was widespread (upper and lower limbs), with a common mechanistic fault of poor transport. The origin of the lymphatic fault is unclear. In healthy individuals, lymphatic abnormalities may be relatively common in the fifth decade of life onward.
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Affiliation(s)
- Emma Cousins
- 1 Molecular and Clinical Sciences Research Institute (Dermatology Unit), St George's, University of London , London, United Kingdom
| | - Viviana Cintolesi
- 1 Molecular and Clinical Sciences Research Institute (Dermatology Unit), St George's, University of London , London, United Kingdom
| | - Laurence Vass
- 2 Department of Medical Physics and Clinical Engineering, St George's University Hospitals NHS Foundation Trust , London, United Kingdom
| | - Anthony W B Stanton
- 1 Molecular and Clinical Sciences Research Institute (Dermatology Unit), St George's, University of London , London, United Kingdom
| | - Andrew Irwin
- 2 Department of Medical Physics and Clinical Engineering, St George's University Hospitals NHS Foundation Trust , London, United Kingdom
| | - Susan D Heenan
- 3 Department of Radiology, St George's University Hospitals NHS Foundation Trust , London, United Kingdom
| | - Peter S Mortimer
- 1 Molecular and Clinical Sciences Research Institute (Dermatology Unit), St George's, University of London , London, United Kingdom .,4 Department of Dermatology, St George's University Hospitals NHS Foundation Trust , London, United Kingdom
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8
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Goss JA, Maclellan RA, Greene AK. Primary Lymphedema of the Upper Extremities: Clinical and Lymphoscintigraphic Features in 23 Patients. Lymphat Res Biol 2019; 17:40-44. [DOI: 10.1089/lrb.2017.0085] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Jeremy A. Goss
- Department of Plastic and Oral Surgery, Lymphedema Program, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Reid A. Maclellan
- Department of Plastic and Oral Surgery, Lymphedema Program, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Arin K. Greene
- Department of Plastic and Oral Surgery, Lymphedema Program, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts
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9
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Rationale for Study of the Deep Subfascial Lymphatic Vessels During Lymphoscintigraphy for the Diagnosis of Peripheral Lymphedema. Clin Nucl Med 2019; 44:91-98. [DOI: 10.1097/rlu.0000000000002400] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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10
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Vignes S, Vidal F, Arrault M, Boccara O. [Primary lymphedema in childhood]. Arch Pediatr 2017; 24:766-776. [PMID: 28651791 DOI: 10.1016/j.arcped.2017.05.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2016] [Revised: 01/27/2017] [Accepted: 05/23/2017] [Indexed: 12/20/2022]
Abstract
Lymphedema results from impaired lymphatic transport with increased limb volume and is divided into primary and secondary forms. In children, primary lymphedema is the most frequent, with a sporadic, rarely familial form or associated with complex malformative or genetic disorders. Diagnosis of lymphedema is mainly clinical and lymphoscintigraphy is useful to assess the lymphatic function of both limbs precisely. The main differential diagnosis is overgrowth syndrome. Erysipelas (cellulitis) is the main complication, but psychological or functional discomfort may occur throughout the course of lymphedema. Lymphedema management is based on multilayer low-stretch bandage, skin care, and eventually manual lymph drainage. The objective of treatment is to reduce lymphedema volume and then stabilize it. Multilayer low-stretch bandage and elastic compression are the cornerstone of treatment. Parent's motivation, including self-management, is required to ensure the child's compliance and improve quality of life.
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Affiliation(s)
- S Vignes
- Unité de lymphologie, Centre national de référence des maladies vasculaires rares (lymphœdèmes primaires), hôpital Cognacq-Jay, 15, rue Eugène-Millon, 75015 Paris, France.
| | - F Vidal
- Unité de lymphologie, Centre national de référence des maladies vasculaires rares (lymphœdèmes primaires), hôpital Cognacq-Jay, 15, rue Eugène-Millon, 75015 Paris, France
| | - M Arrault
- Unité de lymphologie, Centre national de référence des maladies vasculaires rares (lymphœdèmes primaires), hôpital Cognacq-Jay, 15, rue Eugène-Millon, 75015 Paris, France
| | - O Boccara
- Service de dermatologie, hôpital Necker, AP-HP, 149, rue de Sèvres, 75012 Paris, France
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11
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Les lymphœdèmes : du diagnostic au traitement. Rev Med Interne 2017; 38:97-105. [DOI: 10.1016/j.revmed.2016.07.005] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2016] [Accepted: 07/27/2016] [Indexed: 12/28/2022]
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12
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Abstract
INTRODUCTION Lymphedema is characterized by a defect in the lymphatic system that causes limb swelling. Impaired uptake and transport of lymphatic fluid through lymphatic vessels causes accumulation of protein-rich fluid in the interstitial spaces, which leads to swelling of the limb. Primary lymphedema often presents at birth. The rare cases that arise after age 35 years are described as lymphedema tarda. The great majority of patients with lymphedema have swelling of the lower limbs-upper limb lymphedema is a rare disorder. CASE PRESENTATION An 84-year-old woman presented with a 3-year history of unilateral swelling of the right upper limb. There were no constitutional symptoms and no evidence of lymphadenopathy or systemic disease. Blood tests, carcinoembryonic antigen test, computed tomography scans, and venous Doppler ultrasound were all normal. The diagnosis was primary upper limb lymphedema. DISCUSSION The swelling that occurs in upper limb lymphedema is permanent and usually extends to the hand. About one-third of patients with this condition also present with lower limb lymphedema. Thorough investigations are warranted in cases of unilateral upper limb lymphedema to rule out occult malignancy and systemic disease.
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Affiliation(s)
- Michael Ec Mcfarlane
- Consultant General Surgeon and Lecturer in Surgery in the Department of Surgery, Radiology, Anaesthetics and Intensive Care at the University of the West Indies in Mona, Jamaica.
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13
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Vidal F, Arrault M, Vignes S. Paediatric primary lymphoedema: a cohort of 155 children and newborns. Br J Dermatol 2016; 175:628-31. [PMID: 26990193 DOI: 10.1111/bjd.14556] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Affiliation(s)
- F Vidal
- Department of Lymphology, Centre National de Référence des Maladies Vasculaires Rares (Lymphoedèmes Primaires), Hôpital Cognacq-Jay, 15 Rue Eugène-Millon, 75015, Paris, France
| | - M Arrault
- Department of Lymphology, Centre National de Référence des Maladies Vasculaires Rares (Lymphoedèmes Primaires), Hôpital Cognacq-Jay, 15 Rue Eugène-Millon, 75015, Paris, France
| | - S Vignes
- Department of Lymphology, Centre National de Référence des Maladies Vasculaires Rares (Lymphoedèmes Primaires), Hôpital Cognacq-Jay, 15 Rue Eugène-Millon, 75015, Paris, France.
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14
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Blein M, Baulieu F, Vaillant L, Lorette G, Samimi M, Maruani A. Fréquence des anomalies lymphoscintigraphiques infracliniques controlatérales et évolution des lymphœdèmes primaires unilatéraux de l’enfant. Ann Dermatol Venereol 2014; 141:663-70. [DOI: 10.1016/j.annder.2014.06.022] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2014] [Revised: 05/15/2014] [Accepted: 06/19/2014] [Indexed: 12/20/2022]
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Vignes S, Brunet M, Blanchard M, Smail A, Arrault M. Large-Volume Sirolimus-Induced Upper Limb Lymphedema after Renal Transplantation Ipsilateral to the Arteriovenous Fistula. Lymphat Res Biol 2014; 12:185-8. [DOI: 10.1089/lrb.2014.0005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Affiliation(s)
- Stéphane Vignes
- Department of Lymphology, Centre National de Référence des Maladies Vasculaires Rares, Hôpital Cognacq-Jay, Paris, France
| | - Morgan Brunet
- Department of Lymphology, Centre National de Référence des Maladies Vasculaires Rares, Hôpital Cognacq-Jay, Paris, France
| | - Marie Blanchard
- Department of Lymphology, Centre National de Référence des Maladies Vasculaires Rares, Hôpital Cognacq-Jay, Paris, France
| | - Amar Smail
- Department of Internal Medicine, CHU d'Amiens, Hôpital Nord, Amiens Cedex, France
| | - Maria Arrault
- Department of Lymphology, Centre National de Référence des Maladies Vasculaires Rares, Hôpital Cognacq-Jay, Paris, France
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Hacard F, Machet L, Caille A, Tauveron V, Georgescou G, Rapeneau I, Samimi M, Patat F, Vaillant L. Measurement of skin thickness and skin elasticity to evaluate the effectiveness of intensive decongestive treatment in patients with lymphoedema: a prospective study. Skin Res Technol 2013; 20:274-81. [DOI: 10.1111/srt.12116] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/19/2013] [Indexed: 11/28/2022]
Affiliation(s)
- F. Hacard
- Service de dermatologie; CHRU; Tours France
| | - L. Machet
- Service de dermatologie; CHRU; Tours France
- Université François-Rabelais; INSERM U930 Tours France
| | - A. Caille
- Université François-Rabelais; INSERM U930 Tours France
- INSERM; CIC 202 Tours France
| | | | | | | | - M. Samimi
- Service de dermatologie; CHRU; Tours France
| | - F. Patat
- Université François-Rabelais; INSERM U930 Tours France
- CIC-IT; CHRU; Tours France
| | - L. Vaillant
- Service de dermatologie; CHRU; Tours France
- Université François-Rabelais; INSERM U930 Tours France
- INSERM; CIC 202 Tours France
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Shariati F, Ravari H, Kazemzadeh G, Sadeghi R. Isolated primary lymphedema tarda of the upper limb. Lymphat Res Biol 2013; 11:43-5. [PMID: 23531184 DOI: 10.1089/lrb.2012.0027] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Primary lymphedema tarda is considered as a congenital disease with late presentation. Primary lymphedema tarda usually affects lower limbs, and primary lymphedema tarda of the upper limbs usually accompanies lower limb lymphedema. In the current case report, we present an 80-year-old male patient with isolated left upper limb swelling that lymphoscintigraphy imaging proved to be lymphedema.
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Affiliation(s)
- Farzaneh Shariati
- Nuclear Medicine Research Center, Mashhad University of Medical Sciences, Mashad, Iran
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