ISL stage | Description |
0 | A latent or subclinical condition where swelling is not yet evident despite impaired lymph transport, subtle alterations in tissue fluid/composition, and changes in subjective symptoms. It may exist months or years before overt edema occurs (stages I to III). |
I | An early accumulation of fluid relatively high in protein content (eg, in comparison with "venous" edema), which subsides with limb elevation. Pitting may occur. An increase in various types of proliferating cells may also be seen. |
II | Limb elevation alone rarely reduces the tissue swelling and pitting is manifest. Later in stage II, the limb may not pit as excess subcutaneous fat and fibrosis develop. |
III | Lymphostatic elephantiasis where pitting can be absent and trophic skin changes such as acanthosis, alterations in skin character and thickness, further deposition of fat and fibrosis, and warty overgrowths have developed. |
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