2017/02/14 by Shannan McCann, Scott R. Dalton, Todd T. Kobayashi · 1 citation
Medicine · #Lymphatic System and Diseases #Skin Diseases and Diabetes #Autoimmune Bullous Skin Diseases
paper · doi:10.1111/cup.12918
openalex publication_date 2017/02/14 · openalex created_date 2025/10/10 · openalex updated_date 2026/07/22
Bilateral lower extremity inflammatory lymphedema (BLEIL) is a recently described condition that presents with exquisite tenderness, erythema and edema of the lower leg, ankle and dorsal foot resembling an acute cellulitis. It was first reported in healthy, young adult military basic trainees with a normal body mass index during the first 72 hours of arrival to basic training. It occurs while standing at attention for many hours, and shows rapid resolution with elevation and rest. We report an additional case of BLEIL and describe the histopathology of this case and 2 of the previously reported cases. All 3 biopsies showed a deep perivascular infiltrate of neutrophils with karyorrhectic debris and prominent red blood cell extravasation. One of the 3 cases was positive for complement by direct immunofluorescence. We postulate this condition represents a deep leukocytoclastic vascultis with secondary reactive lymphedematous changes.