Although the circulatory system (blood vessels) and the lymphatic system are separate entities in the body, they are very closely linked. Failure or disruption of one system will eventually affect the other.
A backlog of pressure in the veins from such conditions as varicose veins, deep vein thrombosis, leg immobility and heart disease can cause increased leakage from blood vessels into the tissue spaces. This type of swelling is known as a 'low protein" swelling, and usually does not result in the same tissue changes such as fibrosis and skin thickening, as with lymphoedema.
In chronic or ongoing venous or arterial conditions however, the lymphatic system becomes overwhelmed and a mixed picture can emerge of venous (low protein) and lymphoedema (high protein) swelling. Associated skin and tissue changes can then result.
Chronic venous oedema can also lead to a condition called lipodermatoscelerosis, which causes tissues in the lower legs to become inflamed, hardened and narrowed. The shape of the affected leg then takes on an inverted champagne bottle shape. This in turn further affects the lymphatic function and can result in foot swelling below the area of hardness.
Management is based on reducing the hardness and discomfort of the tissues and improving lymph return, often with the help of compression garments, laser and lymphatic massage.
Skin care at home is a crucial factor in reducing the risk of infection and ulceration.