MedifocusHealth

Although the system used for the classification of lymphedema is not universally accepted, the International Society of Lymphology (ISL) issued a consensus statement in 2003 in which it listed a consensus statement regarding diagnosis and treatment of lymphedema. This "best judgment" is accepted by most members of the International Society of Lymphology. The ILS notes that there are four stages of lymphedema:

Stage 0

This is a latent, subclinical condition where there is no overt swelling but lymphatic vessels have been injured and lymphatic pathways disrupted. Stage 0 can exist for several years.

Stage I

This is described as early stage lymphedema where there is fluid accumulation which resolves with elevation of the limb and pitting may be present.

Stage II

This stage is characterized by pitting when the skin is pressed and elevation alone no longer resolves the swelling. Late Stage II involves the formation of fibrosis and less evidence of pitting when skin is pressed.

Stage III

This is a late stage of lymphedema and is also called lymphostatic elephantiasis. At this point there is no pitting, but one or more skin changes, such as fat deposits, warty overgrowths, and acanthosis (a benign thickening of the skin) may appear.

The severity of each stage can be determined by measuring the volume differences between the affected limb and healthy limb.

<20% increase of one limb - indicates minimal severity 20-40% increase - indicates moderate severity

40% increase - indicates a severe stage of lymphedema

Efforts are underway to establish universally accepted guidelines regarding the classification of lymphedema based on additional parameters such as degree of lymph node dysfunction, rate and type of back flow of lymph, and genetic markers.

To read more about the ISL guidelines, please follow this link: http://www.u.arizona.edu/~witte/ISL.htm