Lymphangitis

Not to be confused with lymphadenitis.

Background

• Inflammation of deep dermal/subdermal lymphatic channels
• Usually due to inoculation of skin flora through wound or cellulitis
• Non-infectious lymphangitis much less common, typically due to malignancy

Clinical Features

Forearm lymphangitis due to cellulitis of the hand

Another example of lymphangitis

• Pain
• Fever
• Streaking erythema
• Tenderness to palpation
• +/- tender lymphadenopathy

Differential Diagnosis

Skin and Soft Tissue Infection

• Cellulitis
  • Hand cellulitis
  • Facial cellulitis
  • Orbital cellulitis
• Erysipelas
• Lymphangitis
• Folliculitis
• Hidradenitis suppurativa
• Skin abscess
  • Anorectal abscess
  • Bartholin gland abscess
  • Pilonidal abscess
  • Scrotal abscess
• Necrotizing soft tissue infections
  • Necrotizing fasciitis
  • Necrotizing myositis
  • Necrotizing cellulitis
  • Fournier's gangrene
• Mycobacterium marinum

Look-A-Likes

• Sporotrichosis
• Osteomyelitis
• Deep venous thrombosis
• Pyomyositis
• Purple glove syndrome
• Tuberculosis (tuberculous inflammation of the skin)

Evaluation

• Clinical diagnosis

Management

• Depends on underlying case, but usually IV antibiotics, fluids, analgesia

Disposition

• Depends on underlying cause.
• Does not require admission, per se, but increases its chances as a sign of infection potentially spreading systemically

See Also

• Skin and soft tissue infections