[Classification of lymphedema].

Classification of lymphedema is debated, because authors don't agree with the disordered physiology. Kinmonth divided all cases into primary and secondary lymphedema. Three types of primary lymphedema have been recognized: congenital, precox and tarda. Secondary lymphedema develops as a consequence of disruption or obstruction of the lymphatic pathways. Iatrogenic lymphedema are caused by surgery and/or radiation therapy. Post-infectious lymphedema are mainly caused by filariasis in tropical areas, and by cellulitis in occidental areas. Neoplastic disease (breast, prostatic cancer, Kaposi's sarcoma) are a major cause of secondary lymphedema. Less frequent etiologies are rheumatoid lymphedema, pathomimic lymphedema, pretibial myxoedema. Reduced lymphatic drainage is associated with severe chronic venous insufficiency and contributes to the leg swelling and the risk of infection.