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GIORNALE ITALIANO DI DERMATOLOGIA E VENEREOLOGIA
A Journal on Dermatology and Sexually Transmitted Diseases
Official Journal of the Italian Society of Dermatology and Sexually Transmitted Diseases
Indexed/Abstracted in: EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
Impact Factor 1,014
Giornale Italiano di Dermatologia e Venereologia 2002 April;137(2):99-103
Lymphoedema and local immune surveillance disorders. Related pathologies
Grimaldi Filioli F., Farro P., Di Girolamo F., Vozza G., Ruocco E.
Seconda Università degli Studi - Napoli Clinica Dermatologica
Lymphedema is a disease characterized by lymph accumulation in interstial spaces, due to malformation (primary) or to various disorders of lymphatic vessels (secondary). This condition prefers the body districts with terminal lymph circulation and is usually secondary to infections, inflammations, trauma and radiations. The uncommon primary lymphedema is due to malformations of the lymphatic system. Sometimes lymphedema may be only microscopic, as in the case of AIDS. Apart from etiology and typology, when lymph circulation is obstructed, there are lymphovenous shunt openings and impaired traffic of immune competent cells that may trigger immune tolerance and impairement of immune response in the afferent and efferent limbs. In this circumstance, the lymphedematous district becomes a vulnerable area being exposed to a higher risk to develop neoplastic diseases, infections and, more rarely, disimmune disorders. Among tumors, Kaposi’s sarcoma, mostly the “classic” type, is more often related to lymphedema and represents the ideal model to study physiopathologic mechanisms leading to development of malignancy in the lymphedematous district. On the lymphedematous limb, infective processes are often persistent and relapsing, causing in turn a worsening of lymphedema. Finally, the observation of disimmune disorders developing in lymphedematous regions suggests the existence of more complicated immunologic alterations than a simple local fault of the immune system. Lymphedema, because of its remarkable frequency in the population and particular danger for possible complications, needs more diagnostic and therapeutic care.