Lymphangitis differential diagnosis

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Vendhan Ramanujam M.B.B.S [2]

Overview

The presentation of red streaks on the skin in lymphangitis can also be a presentation of conditions like contact dermatitis, cellulitis, thrombophlebitis, fasciitis and myositis. Clinical finding of red linear streaks proximal to a distal site of infection, along with tender regional lymphadenopathy and fever and history suggestive of infection by causative organisms of lymphangitis helps in differentiating lymphangitis from other conditions.

Differentiating Lymphangitis from other Diseases

  • Contact dermatitis: Contact dermatitis is characterized by onset of symptoms like itching, burning and pain within minutes to hours following exposure to an environmentally relevant allergen and is associated with clinical findings like macular erythema, fissures, or vesicles. Clinical evidences of distal site of infection and tender regional lymphadenopathy are absent.
  • Superficial thrombophlebitis: Clinical findings like erythema, tenderness, induration, or palpable nodular cords along the course of a superficial vein is suggestive of superficial thrombophlebitis. Further evaluation with duplex ultrasound or laboratory studies helps in establishing the diagnosis while differentiating it from lymphangitis.[1]


References

  1. Samlaska CP, James WD (1990). "Superficial thrombophlebitis. II. Secondary hypercoagulable states". J Am Acad Dermatol. 23 (1): 1–18. PMID 2195069.

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