Comment and controversy Edited by Stephen P. Stone, MD| Volume 30, ISSUE 5, P541-543, September 2012

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Phlebolymphedema: Disregarded cause of immunocompromised district

      Recurrent lymphangitis, deep trauma, malignancy, and related treatments (ie surgery and radiotherapy) are usually considered the commonest causes of lymphedema. The role of chronic venous disease in this context is often overlooked; yet, all patients with advanced venous disease (stasis dermatitis) have some degree of lymph circulation impairment.
      • Burton C.S.
      • Burkhart C.N.
      • Goldsmith L.A.
      Cutaneous changes in venous and lymphatic insufficiency.
      Venous edema is assumed to be the sole consequence of increased capillary filtration from venous hypertension. Because lymph drainage is the main buffer against the formation of edema, a compensation for the increased lymph load does occur at the beginning. In the long run, however, when the transport capacity is exceeded, the lymphatics fail to keep their buffer function, and interstitial fluid accumulates. This leads to a clinical condition of mixed venous and lymphatic insufficiency that causes a progressive swelling of soft tissues, which is termed phlebolymphedema.
      • Mortimer P.S.
      Disorders of lymphatic vessels.
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