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Peripheral edema is edema (accumulation of fluid causing swelling) in tissues perfused by the peripheral vascular system, usually in the lower limbs. In the most dependent parts of the body (those hanging distally ), it may be called dependent edema.
Elephantiasis, often incorrectly called elephantitis, is the enlargement and hardening of limbs or body parts due to tissue swelling . [ 1 ] [ 2 ] It is characterised by edema, hypertrophy , and fibrosis of skin and subcutaneous tissues, due to obstruction of lymphatic vessels ( lymphedema ). [ 2 ]
Patients present with an acute onset of swelling, pain, erythema, prominent tenderness, warmness and limited range of motion in both ankles. [1] [2] Lower legs and heels may also be involved, however the distal parts of feet and toes are usually spared. Patients may also experience high-graded fever, pitting edema and hypotension.
Grade 1 (mild edema): Involves the distal parts such as a forearm and hand or a lower leg and foot. The difference in circumference is less than 4 cm (1.6 in) and no other tissue changes are present. Grade 2 (moderate edema): Involves an entire limb or corresponding quadrant of the trunk. Difference in circumference is 4–6 cm (1.6–2.4 in).
The lymphatic system slowly removes excess fluid and proteins from the veins in the lower legs towards the upper body; however, as it is not as efficient as an unimpaired circulatory system, swelling (edema) is visible, particularly in the ankles and lower leg.
Fat deposits/swelling in legs and arms not in hands or feet; hands and feet may be affected as the disease progresses. Fat deposits / swelling widespread in legs/arms/torso: Fat deposits/swelling in one limb including hands and feet: Fat deposits widespread Swelling near ankles; brownish discoloration of lower legs (hemosiderin deposits).
Podoconiosis causes bilateral yet asymmetrical leg swelling with overlying firm nodules. Early on, symptoms may include itching, tingling, widening of the forefoot, and swelling which then progress to soft edema, skin fibrosis, papillomatosis, and nodule formation resembling moss, giving rise to the disease's alternate name of "mossy foot" in some regions of the world. [3]
Ankle pump; Compression stockings; Blood pressure medicine; Hydroxyethylrutoside medication [14] Frequent periods of rest elevating the legs above the heart level; Tilting the bed so that the feet are above the heart. This may be achieved by using a 20 cm (7-inch) bed wedge or sleeping in a 6 degree Trendelenburg position.