The causes of member’s lymphoedema: a retrospective study of 309 cases in Dakar

Abstract

Background: Data on lymphoedema in Africa is scare. Our aim is to determine the epidemiological features and etiological factors of lymphoedema in Dakar. Methodology: A 20 years retrospective study of all patients presented lymphoedema in dermatology department of Aristide Le Dantec hospital in Dakar. Results: 309 cases which representing 0.2% of total consultations were studied. The sex ratio was 0.97 and the average age was 42.4 years. The duration of evolution before the consultation ranged from 11 days to more than 20 years. Lymphedema of the lower limbs was found in 90% and the upper limb in 3.5%. Among patients with lower limb lymphedema, 68.7% had had a unilateral form while upper limbs involvement was bilateral in 18.2%. 6.4% of patient showed multiple localizations. Lymphedema was primary in 14.5%. Among primary lymphedema a case Meige disease and a case of Noone-Milroy syndrome were noted. Secondary causes included bacterial cellulitis in 41.7%, sarcoma of the disease in 31.7%, venous insufficiency in 7.12%, 2.26% in trauma. 100% cases of bacterial dermohypodermitis, 78% cases of Kaposi's disease, 100% cases of venous diseases, 85% of traumatic causes and 75% of iatrogenic lymphedema happened in lower limbs. All multifocal forms were associated with Kaposi's sarcoma. Conclusion: the causes of lymphoedema in tropical regions are dominated by secondary forms mainly bacterial dermohypodermitis and Kaposi disease.