Leg lymphedema is the accumulation of lymphatic fluid in the leg. Lymphedema can be congenital, caused by absence of lymph nodes and vessel, or acquired later in life. Injury to the lymphatic system can cause acquired lymphedema, and it can occur as long as 15 to 20 years after the injury, the NYU Cardiac and Vascular Institute explains. Primary lymphedema affects the legs and feet and is less common than secondary lymphedema, which affects legs or arms. The primary symptom of lymphedema is swelling, which often causes pain.
Swelling
Swelling in the leg is the most obvious symptom of lymphedema. Swelling, which usually extends down to the toes, can be severe and disfiguring. Lymphedema most often occurs on just one side of the body, usually the side that was traumatized, but it can affect both. When swelling first begins, the skin is soft and pliable; pushing down into the swelling leaves an indentation known as pitting edema. Swelling may decrease overnight or after the leg is elevated.This is known as Stage I disease. In Stage II, edema is spongy and can't be compressed by the fingers, and in Stage III, the swelling is irreversible, the Merck Manual states. Treatments include elevation, manual lymphatic massage, to move the lymph fluid out of the leg toward the heart and compression bandages to force the fluid out of the leg.
Discomfort
Lymphedema in the leg causes an aching pain that may make it difficult to stand for any period of time. The leg may feel heavy and difficult to move, making it hard to exercise. Elevating the leg may decrease the swelling and discomfort, particularly in the early stages of the disease.
Infection Susceptibility
Legs affected by lymphedema are more likely to develop skin infections such as cellulitis, lymphangitis or erysipelas, a streptococcal infection because the protein rich lymphatic fluid in the tissue is an excellent medium for bacterial growth, according to the National Lymphedema Network. Signs of infection include fever, redness or red streaks going up the leg toward the heart and pain; the leg may feel warm to the touch. Intravenous antibiotics are often required for infections.
Fibrosis
Fibrosis is a hardening of the skin on the leg that develops in Stage III of lymphedema. The skin may take on an "orange peel" or cobblestone appearance, the Vascular Disease Foundation states. The leg may become very large; lymphedema at this stage is sometimes referred to as elephantiasis, according to the National Lymphedema Network. The leg may become difficult to bend, especially around the ankle, and susceptibility to infection increases.
