Lymphedema
Worth knowing about edema diseases
Lymphedema is not a rare disease. Worldwide about three percent of all people suffer from chronic lymphedema, in Germany it is more than 5 percent. Permanent lymphostasis triggers fibrotic remodelling of the tissue. Therapy should therefore start early. The most important measure is the complex physical decongestion therapy (MLD/KPE). Worldwide, the number of people with chronic lymphedema is estimated to be at least 200 million. The frequency of lymphedema after tumour treatment in industrialised countries - 4.5 million patients in Germany alone (Földi 2004) - and the frequency of filarial infections in Asian and African countries, which are estimated at 120 million (Rheingans 2004), make this figure realistic.
Frequency of lymphedema. If one reads the literature about lymphedema, one notices contradictory statements because of the lymphedema frequency. On the one hand, there is talk of lymphedema, a stepchild of medicine, which is relatively rare and therefore too little known in the medical profession. On the other hand, it is often written that there are 3 million lymphedema cases in Germany alone, although nowhere does it say how this number has arisen. The highest frequency of lymphedema was published in a paper by U. Schwarz from the Földiklinik in 1990, which found the Stemmer's sign, a thickening of the toe back skin typical for primary lymphedema, in an average of 7% on 1000 test persons.
This would result in about 5.6 million primary lymphedema in a population of 80 million people in Germany. If one additionally considers that secondary lymphedema is twice as frequent as primary lymphedema, this would mean a total of about 15 million lymphedema cases in Germany, a truly utopian number. This work by Schwarz inspired me to do my own study, in which I examined 4000 pupils of lymph drainage schools and found a total of 2 primary lymphedema of the legs. This means a frequency of 0.5 ‰, which would mean 40,000 primary lymphedema cases in Germany. Against my study one can argue that this is not a representative study for the entire population, since the average age of 28 years was relatively young. It is possible that the figures would change somewhat as a result of a representative study, but certainly not significantly.
However, there has been no such study to date. It is known from my clinic statistics that secondary lymphedema is regularly twice as frequent as primary lymphedema. From this I must conclude that secondary lymphedema is twice as frequent in the total population, which would mean about 80,000 secondary lymphedema cases in Germany. This would mean a total of approximately 120,000 lymphedema cases in Germany. From my statistics I also know the distribution within primary and secondary lymphedema. In primary lymphedema 94% are on the legs, 1% on the arms, 0.5% on the head, 0.5% on the genitals and 4% on several body regions. In secondary lymphedema, 66% affect the arms, 31% the legs, 1.5% the genitals and 1% the head and 2% several body regions. In terms of frequency, this results in about 53,000 secondary arm lymphedema, about 38,000 primary leg lymphedema and about 25,000 secondary leg lymphedema in Germany.Lipedema disease.Due to the ratio of lymphedema and lipedema in oedema clinics, I estimate the incidence to be 80,000 in Germany. The pure form of lipohypertrophy of the extremities and lipedema without additional obesity is only found in 20% of cases. This means that 80% of lipoedema patients also have obesity, which can worsen the clinical picture. The numbers are a bit older, so the assumption is that the numbers are higher.
