Lymphology Association of North America (LANA) Practice Exam

A patient with lymphedema exhibits splotchy redness, warmth, and swelling. What is the most likely cause?

1. Cellulitis (erysipelas). Stop therapy and inform the physician.

2. Dermatitis. Apply hydrocortisone cream and bandage.

3. Malignant lymphedema. Continue MLD and bandaging.

4. A deep vein thrombosis. Send the patient to the ER.

The correct answer is: Cellulitis (erysipelas). Stop therapy and inform the physician.

In the scenario described, where a patient with lymphedema exhibits splotchy redness, warmth, and swelling, the most likely cause is cellulitis, which is often referred to as erysipelas when it presents in a more superficial form. This bacterial skin infection is characterized by inflammation, warmth, and redness, making it a critical condition that requires immediate medical attention. When lymphedema patients present with these symptoms, it often indicates an infection, as the compromised lymphatic system can make them more susceptible to pathogens. Immediate intervention is crucial to prevent the infection from spreading or worsening. Stopping therapy and informing the physician allows for prompt evaluation and appropriate management, as the standard treatments for lymphedema, such as manual lymphatic drainage (MLD) and bandaging, could potentially exacerbate the condition if an underlying infection is present. The other choices suggest management strategies that would not address the urgent need for medical intervention in the case of cellulitis. Dermatitis would typically present differently and generally would not be associated with the same level of systemic risk as cellulitis. Continuing manual lymphatic drainage in the presence of an active infection is inappropriate as it can promote the spread of the infection. Lastly, while a deep vein