Published online Nov 12, 2013. doi: 10.5499/wjr.v3.i3.40
Revised: July 4, 2013
Accepted: July 17, 2013
Published online: November 12, 2013
In the literature, although the prevalence of lymphedema is low in inflammatory rheumatological diseases, rigorous approaches to diagnosis and treatment have led to significant improvement in patients’ quality of life. Lymphedema is observed more frequently in patients with rheumatoid arthritis with respect to case presentations, but it is also observed in psoriatic arthritis, ankylosing spondylitis, systemic sclerosis, and childhood inflammatory rheumatological diseases. Other rheumatological diseases and tumor-related secondary causes should also be kept in mind in the diagnosis of lymphedema. Complex decongestive therapy-skin care, manual lymph drainage, compression and exercise are the primary treatment approaches. Both basic drugs and tumor necrosis factor-α inhibitors have been tried in addition to complex decongestive physiotherapy programs. However, the success of alternative medical treatments is controversial in the literature. It may be useful to include the disease in post-diagnosis complex decongestive physiotherapy program and to use the drugs mentioned in the literature. However, more data are needed to reach conclusive results.
Core tip: Coexistence of inflammatory rheumatological diseases and lymphedema is an under-recognized subject. Drawing clinicians’ attention to this issue is important for improving patients’ quality of life. In patients with inflammatory rheumatological disease and lymphedema, although the complex decongestive therapy method is the primary approach, tumor necrosis factor-α inhibitors mentioned in the literature, whose efficacy requires explanation, may also be tried.