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Acute or chronic inflammation of lymphatic channels due to a skin breach or local trauma; presents as red, tender streaks along lymphatic channels extending to regional lymph nodes
- May result from compromised lymphatic drainage following surgical procedures
- May be infectious or noninfectious
Etiology and Pathophysiology
- Acute infection
- Usually caused by group A β-hemolytic Streptococcus
- Less commonly caused by:
- Staphylococcus aureus
- Pasteurella multocida
- Spirillum minus (rat bite disease)
- Other Streptococcus sp.
- Immunocompromised patients can be infected with gram-negative rods, gram-negative bacilli, or fungi.
- In fresh water exposures, Aeromonas hydrophila
- Nodular lymphangitis
- Also known as sporotrichoid lymphangitis
- Painful or painless nodular subcutaneous swellings along lymphatic vessels
- Lesions may ulcerate with accompanying regional lymphadenopathy.
- Typical of infections from: Sporothrix schenckii, Nocardia brasiliensis, Mycobacterium marinum, leishmaniasis, tularemia, and systemic mycoses
- Pathology may show granulomas.
- Noninfectious granulomatous lymphangitis
- Filarial lymphangitis
- Mosquito bites transmit parasites causing lymphatic inflammation and dilatation; can predispose to secondary bacterial infection
- Usually caused by nematodes Wuchereria bancrofti. Other causes include Brugia malayi and Brugia timori.
- Lymphangitis can occur after surgical procedures and lymph node dissection.
- Cutaneous lymphangitis carcinomatosa is rare. Represents ~5% of all skin metastases; caused by neoplastic occlusion of dermal lymphatic vessels (2)
- Sclerosing lymphangitis of the penis
- Swelling around coronal sulcus of penis as a result of vigorous sexual activity or masturbation
- Impaired lymphatic drainage due to surgery, nodal dissection, or irradiation
- Diabetes mellitus
- Chronic steroid use
- Peripheral venous catheter
- Varicella infection
- Immunocompromising condition
- Human, animal, or insect bites; skin trauma
- Fungal, bacterial, or mycobacterial skin infections
- IV drug abuse
- Residence in endemic areas of filariasis
- Reduce chronic lymphedema with compression devices or by treating underlying process.
- Insect repellant; arthropod bite precautions
- Proper wound and skin care
Commonly Associated Conditions
- Prior lymph node dissection
- Tinea pedis (athlete’s foot)
- Cellulitis, erysipelas
- Filarial infection (W. bancrofti)