Lymphoscintigraphic evaluation in patients after erysipelas

Erysipelas (cellulitis/lymphangitis) is a superficial cutaneous infection s pread by the lymphatic system which may result ill permanent injury to the lymphatic vessels. The study evaluated the lymphatic drainage in the lower limbs of 30 patients with at least two episodes of erisipelas by means of l ymphoscintigraphy. Twenty-two (73%) were female and 8 (27%) were male with ages ranging from 2 6 to 77 years (mean 52 years). Lymphoscintigraphy was performed by intrader mal administration of 500 mu Ci (20 Mbq) of Tc-99m antimony sulfur-colloid in two interdigital spaces of the feet. Whole body scintigraphy was perform ed 45 minutes after the administration of the radiopharmaceutical using a c omputerized gamma camera. Significant lymphatic abnormalities were found in 23 (77%) of these patients. We conclude that most patients with repeated erysipelas have significant an d even permanent abnormalities in regional lymphatic drainage. Recurrent er ysipelas suggests underlying primary or secondary lymphedema.