Vascular

Question 1

Inability to lift the skin on the dorsum of the second toe (positive Stemmer sign)

Answer 1

Lymphedema

• Physical disruption of lymphatic drainage 2/2:
  
  • Radiation, LN removal
  • Malignant obstruction
  • Recurrent cellulitis
  • Parasitic infection (e.g. filariasis)
  • Congenital (Turner Syndrome)
• Tx: Weight loss, limb elevation, compression bandages, & physiotherapy (e.g. lymphatic drainage by massage;
• Diuretics contraindicated