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Edema may be described as pitting edema, or non-pitting edema. [32] Pitting edema is when, after pressure is applied to a small area, the indentation persists after the release of the pressure. Peripheral pitting edema, as shown in the illustration, is the more common type, resulting from water retention.
Lymphedema can occur in both the upper and lower extremities, and in some cases, the head and neck. Assessment of the extremities first begins with a visual inspection; color, presence of hair, visible veins, size and any sores or ulcerations are noted. Lack of hair may indicate an arterial circulation problem. [34]
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.
[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. The clinical presentation usually resembles cellulitis, however bilateral involvement is a differentiating feature.
Treatment options for PTS include proper leg elevation, compression therapy with elastic stockings, or electrostimulation devices, pharmacotherapy (pentoxifylline), herbal remedies (such as horse chestnut, rutosides), and wound care for leg ulcers. [1] [21] The benefits of compression bandages is unclear. They may be useful to treat edemas. [7]
Myxedema's characteristic physical sign is non-pitting edema, in contrast to pitting edema. [1] Myxedema can also occur in the lower leg (pretibial myxedema) and behind the eyes (exophthalmos). [citation needed] Severe cases, requiring hospitalization can exhibit signs of hypothermia, hypoglycemia, hypotension, respiratory depression, and coma.
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Treatment to protect the airway may include intubation or cricothyroidotomy. [1] Histamine-related angioedema can be treated with antihistamines, corticosteroids, and epinephrine. [1] In those with bradykinin-related disease a C1 esterase inhibitor, ecallantide, or icatibant may be used. [1] Fresh frozen plasma may be used instead. [1]
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