ArticleBMC infectious diseases2024
Factors associated with cellulitis in lymphoedema of the arm - an international cross-sectional study (LIMPRINT).
Article in BMC infectious diseases, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 1 of them a synthesis that pooled it.
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Who cites it
11 citing papers in PubMed, 1 synthesis or guideline pooled it, 18 citations in OpenAlex.
- Pharmacotherapy agents in prevention and treatment of breast cancer-related lymphedema: a systematic scoping review.Frontiers in oncology · 2026Pooled it
- Efficacy of Inelastic Compression Devices with a High Stiffness in Older Breast Cancer Survivors with Moderate and Severe Lymphedema: A Prospective Interventional Study.Journal of clinical medicine · 2026Article
- Epithelial-Dermal Immune Memory: TrackingInternational journal of molecular sciences · 2026Review
- Breast Edema in Women With Arm Lymphedema Following Breast-Conserving Surgery: A Systematic Review.Cureus · 2026Review
- Effect of prior mastectomy on outcomes following total shoulder arthroplasty.Archives of orthopaedic and trauma surgery · 2026Article
- Clinical Features, Microbial Epidemiology, and Recurrence Risk of Cellulitis in Breast Cancer-Related Lymphedema.Annals of surgical oncology · 2026Article
- Women's and practitioners' views of early intensive decongestive lymphoedema treatment for breast cancer-related arm lymphoedema: a focus group study.Journal of cancer survivorship : research and practice · 2025Article
- Effects of 4-Week Complex Decongestive Therapy in the Management of Breast Cancer-Related Arm Lymphedema in Montenegrin Women Post-Mastectomy and Chemo/Radiotherapy.Healthcare (Basel, Switzerland) · 2025Article
- The prognostic effect and mechanism of erysipelas in cancer-associated lymphedema.Scientific reports · 2025Article
- Comfortable knowing little about lymphoedema? A qualitative study of medical interns in Australia.BMJ open · 2025Article
- Exploring barriers to accessing treatment for Lymphatic Filariasis through a socio-ecological lens in Buvuma and Napak districts, Uganda.PLoS neglected tropical diseases · 2025Article
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Authors and funding
9 authors at 5 institutions in 5 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundLymphoedema is a globally neglected health care problem and a common complication following breast cancer treatment. Lymphoedema is a well-known predisposing factor for cellulitis, but few have investigated the risk factors for cellulitis in this patient cohort on an international level. The aim of this study was to identify the frequency of cellulitis in patients with lymphoedema of the arm, including potential risk factors for cellulitis.
methodsAn international, multi-centre, cross-sectional study including patients with clinically assessed arm lymphoedema. The primary outcome was the incidence of cellulitis located to the arm with lymphoedema within the last 12 months, and its potential associated risk factors. The secondary outcome was life-time prevalence of cellulitis. Adults with clinically-assessed arm lymphoedema/chronic oedema (all causes) and able to give informed consent were included. End-of-life-patients or those judged as not in the patient's best interest were excluded. Both univariable and multivariable analysis were performed.
resultsA total of 2160 patients were included from Australia, Denmark, France, Ireland, Italy, Japan, Turkey and United Kingdom. Secondary lymphoedema was present in 98% of the patients; 95% of these were judged as related to cancer or its treatment. The lifetime prevalence of cellulitis was 22% and 1-year incidence 11%. Following multivariable analysis, factors associated with recent cellulitis were longer swelling duration and having poorly controlled lymphoedema. Compared to having lymphoedema less than 1 year, the risk increased with duration: 1-2 years (OR 2.15), 2-5 years (OR 2.86), 5-10 years (OR 3.15). Patients with well-controlled lymphoedema had a 46% lower risk of cellulitis (OR 0.54, 95% CI 0.39-0.73, p < 0.001). More advanced stages of lymphoedema were associated with cellulitis even after adjustment for swelling duration and control of swelling by logistic regression (stage II OR 5.44, stage III OR 9.13, p = 0.002), demonstrated in a subgroup analysis.
conclusionPatients with advanced arm lymphoedema are at particular risk of developing cellulitis. Prevention of lymphoedema progression is crucial. The results lend towards a positive effect of having well-treated lymphoedema on the frequency of cellulitis.
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