Signs of lymphedema development include slow progression of swelling which is typically distal to proximal progression. In stage I, this swelling may be eliminated with simple elevation. With increased protein-rich swelling, there is a risk for bacteria growth and infection. Several skin changes may occur with the development of lymphedema. This infection can spread quickly, so early diagnosis and treatment is the key to keeping the infection and swelling under control.
Pitting edema is present when a hollow is formed in the skin by applying finger pressure.
This is often times seen with a recent accumulation of fluid and protein. Two other skin changes, called hyperkeratosis and papillomas may also be seen in someone with lymphedema. Hyperkeratosis is an overgrowth of the horny layer of the skin that presents as nodules usually on the toes. Papillomas are raised wart-like growths that can appear on the skin of people with longstanding lymphedema. There are four main areas that physicians evaluate to determine a diagnosis of lymphedema.