Prevalence and risk factors of lymphatic dysfunction in cirrhosis patients with refractory ascites: An often unconsidered mechanism

Figure 2 Representative images showing two distinct patterns of peripheral edema among cirrhosis patients with refractory ascites. A and B: Physical appearance of peripheral edema revealed two distinct patterns. In the majority of patients, edema was pitting type and skin texture was smooth (A), which is a finding consistent with edema due to the hydrostatic-oncotic pressure imbalance. In about one-third of patients, edema was severe, mostly non-pitting type with skin texture showing exaggerated dorsal skin creases, hyperkeratosis, and peau d’orange appearance (B), suggesting lymphedema. Some patients with lymphedema also had evidence of cellulitis.