Lymphangiectasia Treatment & Management

Updated: Apr 09, 2021
  • Author: Robert A Schwartz, MD, MPH; Chief Editor: Dirk M Elston, MD  more...
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Medical Care

Topical sirolimus 0.1% for cutaneous microcystic lymphatic malformations in children and adults is now the subject of a clinical trial since it has been reported as effective in a few patients. [34]

Treatment for lymphangiectases can be difficult, but it is important because of the risk that ruptured vesicles may provide a portal of entry for infection and subsequent cellulitis. To prevent superinfection of ruptured vesicles, cleansing the affected area daily with topical antibacterial agents and applying mupirocin ointment or silver sulfadiazine cream are advisable.

Follow-up care is essential for early treatment of lymphangiectasia recurrences. Lymphangiosarcoma (Stewart-Treves syndrome) may occur in chronic edematous limbs, and early detection is critical. At times, severe recurrent cellulitis may warrant hospitalization in patients with lymphangiectasia, especially in patients who are immunocompromised. Intravenous antibiotic is required in patients with severe cellulitis.


Surgical Care

Many surgical treatment modalities have been advocated in the care of lymphangiectases; these modalities include electrodesiccation, laser therapy, [10] sclerotherapy, [35] cryotherapy, and surgical excision. [23, 36] In a small case series, liquid nitrogen cryotherapy was an effective treatment for localized conjunctival lymphangiectasia. [37] Successful treatment of conjunctival lymphangiectasia has been described using a high-frequency radiowave electrosurgical device. [38] Daily compression through bandaging or hosiery, in accessible areas, has yielded acceptable results. Although no consensus exists concerning therapy for lymphangiectasia, vulvar lymphangiectasia may be effectively handled with carbon dioxide laser therapy. [39] Acquired balanic lymphangiectasia after circumcision was successfully treated with a 2940-nm erbium-doped yttrium aluminium garnet laser. [40]