Acquired Lymphangiectasia — SCE Dermatology MCQ

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HardDermatological SurgeryAcquired LymphangiectasiaSCE Dermatology

A 45-year-old woman presents with acquired progressive lymphangioma (lymphangiectasia). She has multiple grouped translucent vesicle-like papules on her inner thigh oozing clear lymph fluid. She had lymph node dissection for melanoma 2 years ago. What is the cause?

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Correct answer: C — Acquired lymphangiectasia secondary to lymphatic obstruction from prior lymph node dissection

Acquired lymphangiectasia presents as clusters of translucent/clear vesicle-like papules that weep clear lymph fluid. It results from superficial lymphatic dilation secondary to lymphatic obstruction — in this case from prior lymph node dissection for melanoma. Other causes include radiotherapy, chronic infection, and Crohn disease. The condition mimics vesicular eruptions (herpes, contact dermatitis) but the clear lymphatic fluid content and history of lymphatic disruption are diagnostic. Treatment options are limited: compression, cautery, laser ablation (CO2 or Nd:YAG), or sclerotherapy. Prevention of secondary cellulitis (a common complication of lymphoedema) with skin care and prompt antibiotic treatment of infections is important.

Reference: BAD 2019; Lymphoedema Framework