[Adverse effects of compression in treatment of limb lymphedema].
BACKGROUND
Limb lymphedema, whether primary or secondary, is a chronic disease. Compression is the cornerstone of therapy and includes multilayer low-stretch bandages and elastic garments. Compression is usually well-tolerated. The aim of our study was to identify all the different types of adverse effects of compression.


METHODS
Since January 2005, we have recorded all adverse events occurring in outpatients and inpatients consulting in a single lymphology department, spontaneously reported by patient during consultations or physical examinations, and noted the type of compression material used.


RESULTS
Adverse effects were secondary to poor choice of therapeutic material, excessive pressure or contact dermatitis. For the arms, an elastic garment stopping at the wrist can be responsible for lymphedema of the hand and fingers. Rubbing of sleeve seams may cause pain and even ulcers between the thumb and forefinger. Open-toed elastic stockings may exacerbate digital lymphedema, leading to the formation of oozing lymph vesicles. Hyperpressure may cause severe pain localized to the first and fifth toes, overlapping toes, interdigital corns and/or ingrown toenails. Silicone-banded soft-fit elastic garments may cause painful phlyctena, urticaria or eczematiform lesions. Elastic bandages may induce pain or purpuric lesions.


CONCLUSIONS
Compression can be responsible for adverse effects, sometimes severe, requiring treatment change or withdrawal. Further studies are needed to precisely determine their frequency to improve prescriptions and currently available products.
Vignes
S
S
Unité de lymphologie, centre national de référence des maladies vasculaires rares, hôpital Cognacq-Jay, 15, rue Eugène-Millon, 75015 Paris, France. stephane.vignes@hopital-cognacq-jay.fr
Arrault
M
M
D001132:Arm; D001458:Bandages / Q000009:adverse effects*; D003020:Clothing / Q000009:adverse effects; D003877:Dermatitis, Contact / Q000209:etiology; D004548:Elasticity; D004867:Equipment Design; D005260:Female; D006801:Humans; D007866:Leg; D008209:Lymphedema / Q000150:complications / Q000628:therapy*; D008297:Male; D009260:Nail Diseases / Q000209:etiology; D010146:Pain / Q000209:etiology; D011312:Pressure / Q000009:adverse effects*; D011693:Purpura / Q000209:etiology; D012883:Skin Ulcer / Q000209:etiology; D053828:Stockings, Compression / Q000009:adverse effects