CPL is a progressive disease, which begins below the fetlock and gradually moves up the leg. All legs are affected, the hindlimbs usually more seriously so. Initial signs include thickening, crusting and folding of the skin. These early signs may be hidden by the long hair (feather) on the horse's lower legs. Affected areas are itchy, causing the horse to stamp its feet and rub its legs, and painful, so that the horse may be reluctant to allow its legs to be touched. As CPL progresses, ulcers develop on the pasterns, and fibrosis leads to hardening of the skin and the development of nodules which may become baseball sized. Secondary infections with microbes or mites commonly cause complications. Infestations with the mange mite "Chorioptes equi" are very itchy, and lead to self-trauma and dermatitis.

The quality of the hoof is often poor; hooves are prone to cracks, splits and the development of thrush and abscesses; horses may develop laminitis. Chestnuts and ergots are often misshapen and irregular.

Chronic progressive lymphedema (CPL) is a disease of some breeds of draft horse, whereby the lower legs becomes progressively more swollen. There is no cure; the aim of treatment is to manage the signs and slow progression of the disease. The cause of CPL is not known, although it is suspected that a genetic disorder of elastin metabolism prevents the lymphatic vessels from functioning properly, leading to edema of the lower limbs. CPL resembles the human disease elephantiasis verrucosa nostra.

The disease usually affects the lower legs or scrotum. The swelling is accompanied by rough nodules or wart-like plaques on the skin. If the disease is not treated, it eventually results in pain and immobility.

The primary symptom of podoconiosis is swelling and disfigurement of the lower extremities. The swelling can either be soft and fluid or hard and fibrotic. Multiple firm nodules may develop over time, as well as hyperkeratotic papillomata that resemble moss, which has led to the disease's alternate name of Mossy Foot. The edema of podoconiosis is usually bilateral and asymmetric. Prior to the development of lymphatic failure and frank lymphedema, a prodrome consisting of itching, burning, hyperkeratosis, plantar edema, and rigid digits may occur. As with other forms of tropical lymphedema, chronic disease can lead to fusion of the toes, ulceration, and bacterial superinfection. The disease has an acute component, and sufferers may experience recurrent episodes of lower extremity warmth, firmness, and pain.

Although elephantiasis nostras resembles the elephantiasis caused by helminths, it is not a filarial disease. Instead, it is a complication of chronic lymphedema. Both elephantiasis nostras and filarial elephantiasis are characterized by impaired lymphatic drainage, which results in excess fluid accumulation.

Stasis Papillomatosis is similar to AGEP (Acute generalized exanthematous pustulosis) from pustular psoriasis; criteria for histopathologic distinction have been proposed: papillary edema, vasculitis, exocytosis of eosinophils and single-cell necrosis of keratinocytes in AGEP and acanthosis and papillomatosis in pustular psoriasis.

An example that illustrates the difference between SP and Stasis Papillomatosis and the histology diagnosis is … “a markedly obese, 41-year-old Japanese man who had suffered from psoriasis vulgaris for several years visited hospital with elephantiasis-like swelling of his lower legs of three months' duration. His right lower leg showed marked papillomatosis with thick scales, and the left lower leg was eroded and papillomatous. Although direct lymphography of his lower extremities showed no abnormality, indirect lymphography revealed local lymphatic damage in the involved skin”. Histological examination showed hyperkeratosis, marked papillomatosis, proliferation of capillaries in the upper dermis, and lymphectasia in the lower dermis. It was suspected that obesity and the preceding psoriatic lesions caused local lymphatic disturbances, followed by the development of stasis papillomatosis.

Chronic inflammation can cause long term lymphatic obstruction. Typically, patients have disorders that present local nodes, primary lymphedema and chronic venous insufficiency. Erysipelas and trauma are major risk factors. Lymphatic edema can be developed in many acral cases accompanied by a thickening of the folds of the skin, hyperkeratosis and papillomatosis. Chronic venous edema is only partially reversible and soon becomes hard, especially confirming tenderness. All structures of the skin are affected. Dilated dermal lymphatic vessels with consequent superior organization and fibrosis result in papillomatosis. As dermal lymphatic stasis progreses, these skin changes become more marked and known as elephantiasis. Occasionally, tissue fibrosis and thickening may become so marked in the later stages of lymphedema that pitting is absent. Recurrent cellulitis, erysipelas and dermato-LAM-adenitis are complications of chronic lymphedema.

The nails are markedly thickened with yellow to yellow-green discoloration of the nails. They grow slowly, at a rate of 0.25 mm/week or less. The nails may have ridges and increased side-to-side curvature, reduction of the white crescent and detachment of the nail from the nailbed. The nail changes may change over time.

Most people with yellow nail syndrome (four fifths) have lymphedema; it is symmetrical and typically affects both legs. It is the first symptom of the condition in about a third. Involvement of the arms and face is more unusual, as is lymphedema of the abdomen with ascites (fluid collection in the abdominal cavity) and fluid collection around the heart.

Various lung problems can occur in people with yellow nail syndrome. Many experience cough and shortness of breath. Forty percent of cases develop pleural effusions, which are collections of fluid in the pleural cavity (the space that contains the lungs and normally only has a minimal amount of fluid in it). About half of all people with yellow nail syndrome have either recurrent chest infections or a chronic lung condition known as bronchiectasis which causes chronic production of sputum with episodes of worsening. Forty percent of people with yellow nail syndrome have chronic sinusitis.

Yellow nail syndrome has been associated with some drugs, "e.g." penicillamine, bucillamine and gold sodium thiomalate.

Podoconiosis, also known as nonfilarial elephantiasis, is a disease of the lymph vessels of the lower extremities that is caused by chronic exposure to irritant soils. It is the second most common cause of tropical lymphedema after filariasis, and it is characterized by prominent swelling of the lower extremities, which leads to disfigurement and disability.

The clinical manifestation and presentation of symptoms of lymphedema develop following a significant degree of injury. Secondary lymphedema is the lymphadenectomy and lymphatic injury following surgery, radiation, chemotherapy, and/or trauma which healing or regeneration of damaged lymphatics may occur with variable success.

Symptoms will include swelling, edema, and pain from a multitude of secondary complications (pressure, musculoskeletal disorder from asymmetry, restricted blood flow). Most patients will avoid discussing pain for many reasons, so this will require logical thinking or communication skills to assess. In advanced lymphedema, there may be the presence of skin changes such as discoloration, verrucous (wart-like) hyperplasia, hyperkeratosis, papillomatosis, and Ulcer (dermatology).

Lymphedema should not be confused with edema arising from venous insufficiency, which is not lymphedema. In addition to a compressive local environment of lymphedematous extremity, long standing venous compression potentially contributed to an increased propensity for thrombosis due to vascular changes from longstanding venous hypertension from a proximal compression or simply from a change in blood flow. However, untreated venous insufficiency can progress into a combined venous/lymphatic disorder. Proper imaging can help identify where the dysfunction is in the system, and is essential in identifying the source before treatment is decided.

Presented here is an extreme case of severe unilateral hereditary lymphedema which had been present for 25 years without treatment:

Yellow nail syndrome, also known as "primary lymphedema associated with yellow nails and pleural effusion", is a very rare medical syndrome that includes pleural effusions, lymphedema (due to under development of the lymphatic vessels) and yellow nails. Approximately 40% will also have bronchiectasis. It is also associated with chronic sinusitis and persistent coughing. It usually affects adults.

The most common presentation of Milroy Disease is bilateral lower extremity lymphedema, and may also be accompanied by hydrocele.

Postinflammatory lymphedema is a condition characterized by swelling of the soft tissues in which an excessive amount of lymph has accumulated, and is caused by repeated bacterial infections.

Lymphedema affects approximately 140 million people worldwide.

Lymphedema may be inherited (primary) or caused by injury to the lymphatic vessels (secondary). It is most frequently seen after lymph node dissection, surgery and/or radiation therapy, in which damage to the lymphatic system is caused during the treatment of cancer, most notably breast cancer. In many patients with cancer, this condition does not develop until months or even years after therapy has concluded. Lymphedema may also be associated with accidents or certain diseases or problems that may inhibit the lymphatic system from functioning properly. In tropical areas of the world, a common cause of secondary lymphedema is filariasis, a parasitic infection. It can also be caused by a compromising of the lymphatic system resulting from cellulitis.

While the exact cause of primary lymphedema is still unknown, it generally occurs due to poorly developed or missing lymph nodes and/or channels in the body. Lymphedema may be present at birth, develop at the onset of puberty (praecox), or not become apparent for many years into adulthood (tarda). In men, lower-limb primary lymphedema is most common, occurring in one or both legs. Some cases of lymphedema may be associated with other vascular abnormalities.

Secondary lymphedema affects both men and women. In women, it is most prevalent in the upper limbs after breast cancer surgery, in particular after axillary lymph node dissection, occurring in the arm on the side of the body in which the surgery is performed. Breast and trunk lymphedema can also occur but, go unrecognised as there is swelling in the area after surgery and its symptoms ( peau d' orange and/or an inverted nipple ) can be confused with post surgery fat necrosis. In Western countries, secondary lymphedema is most commonly due to cancer treatment. Between 38 and 89% of breast cancer patients suffer from lymphedema due to axillary lymph node dissection and/or radiation. Unilateral lymphedema occurs in up to 41% of patients after gynecologic cancer. For men, a 5-66% incidence of lymphedema has been reported in patients treated with incidence depending on whether staging or radical removal of lymph glands was done in addition to radiotherapy.

Head and neck lymphedema can be caused by surgery or radiation therapy for tongue or throat cancer. It may also occur in the lower limbs or groin after surgery for colon, ovarian or uterine cancer, in which removal of lymph nodes or radiation therapy is required. Surgery or treatment for prostate, colon and testicular cancers may result in secondary lymphedema, particularly when lymph nodes have been removed or damaged.

The onset of secondary lymphedema in patients who have had cancer surgery has also been linked to aircraft flight (likely due to decreased cabin pressure or relative immobility). For cancer survivors, therefore, wearing a prescribed and properly fitted compression garment may help decrease swelling during air travel.

Some cases of lower-limb lymphedema have been associated with the use of tamoxifen, due to the blood clots and deep vein thrombosis (DVT) that can be caused by this medication. Resolution of the blood clots or DVT is needed before lymphedema treatment can be initiated.

The initial trauma causing the infection is often forgotten or not noticed. The infection builds at the site over a period of years, and a small red papule (skin elevation) appears. The lesion is usually not painful, with few, if any symptoms. Patients rarely seek medical care at this point.

Several complications may occur. Usually, the infection slowly spreads to the surrounding tissue while still remaining localized to the area around the original wound. However, sometimes the fungi may spread through the blood vessels or lymph vessels, producing metastatic lesions at distant sites. Another possibility is secondary infection with bacteria. This may lead to lymph stasis (obstruction of the lymph vessels) and elephantiasis. The nodules may become ulcerated, or multiple nodules may grow and coalesce, affecting a large area of a limb.

People tend to gain weight in lipedematous areas and lose it in non-lipedematous areas, though there are cases where weight loss has resulted in improvement of the condition. Obese lipedema patients who undergo bariatric surgery lose fat primarily from the waist up. While lipedema presents itself in various ways, diagnosis is possible as early as pre-puberty when inner thigh pads present and at any age when fat gathers and drapes at knees.

Symptoms of lipedema include disproportionately large, column-like legs, legs unusually large to the knees, disproportionate hips, stomach or buttocks. As lipedema progresses, patients become increasingly heavy in the lower body. The additional, expanding fat cells interfere with the pathways of lymphatic vessels, and patients can develop secondary lymphedema, a condition known as lipo-lymphedema. Many lipedema patients cannot tolerate the compression garments associated with conventional lymphedema treatment because the underlying lipedematous fat is very painful, and those patients therefore are at risk for the side effects of uncontrolled lymphedema, including recurring blood infections and fibrosis. If not kept in check through a healthy lifestyle, lipo-lymphedema can worsen, and patients will become progressively less mobile.

Bullous lymphedema is a skin condition that usually occurs with poorly controlled edema related to heart failure and fluid overload, and compression results in healing.

The rash caused by ACA is most evident on the extremities. It begins with an inflammatory stage with bluish red discoloration and cutaneous swelling, and concludes several months or years later with an atrophic phase. Sclerotic skin plaques may also develop.As ACA progresses the skin begins to wrinkle.

Factitial lymphedema (also known as "Hysterical edema") is a skin condition produced by wrapping an elastic bandage, cord, or shirt around an extremity, and/or holding the extremity in a dependent and immobile state.

Primary lymphedema is a form of lymphedema which is not directly attributable to another medical condition.

It can be divided into three forms, depending upon age of onset: congenital lymphedema, lymphedema praecox, and lymphedema tarda.

Congenital lymphedema presents at birth. Lymphedema praecox presents from ages 1 to 35. This type of lymphedema accounts for 77–94% of all cases of primary lymphedema. Lymphedema tarda presents after age 35. This type of lymphedema usually develops as a result of a developmental abnormality being precipitated by some insult such as trauma, illness, or physical immobility. Compared to secondary lymphedema, primary lymphedema is more likely to involve the face, conjunctiva, and genitalia in association with any limbs involved.

It can be familial.

Elephantiasis is a symptom of a variety of diseases, where parts of a person's body swell to massive proportions.

Some conditions that have this symptom include:

- Elephantiasis nostras, due to longstanding chronic lymphangitis

- Elephantiasis tropica or lymphatic filariasis, caused by a number of parasitic worms, particularly "Wuchereria bancrofti". More than 120 million people, mostly in Africa and Southeast Asia, are affected.

- Nonfilarial elephantiasis or podoconiosis, an immune disease affecting the lymph vessels

- Elephantiasis, Grade 3 lymphedema which may occur in people with breast cancer.

- Genital elephantiasis, end result of lymphogranuloma venereum

- Proteus syndrome, the genetic disorder of the so-called Elephant Man.

Chromoblastomycosis (also known as chromomycosis, cladosporiosis, Fonseca's disease, Pedroso's disease, phaeosporotrichosis, or verrucous dermatitis) is a long-term fungal infection of the skin and subcutaneous tissue (a chronic subcutaneous mycosis). The infection occurs most commonly in tropical or subtropical climates, often in rural areas. It can be caused by many different types of fungi which become implanted under the skin, often by thorns or splinters. Chromoblastomycosis spreads very slowly; it is rarely fatal and usually has a good prognosis, but it can be very difficult to cure. The several treatment options include medication and surgery.

Lipedema is a disorder where there is enlargement of both legs due to deposits of fat under the skin. Typically it gets worse over time, pain may be present, and people bruise easily. In severe cases the trunk and upper body may be involved.

The cause is unknown but is believed to involve genetics and hormonal factors. It often runs in families. Risk factors include being overweight or obese. Other conditions that may present similarly include obesity, lipohypertrophy, chronic venous insufficiency, and lymphedema.

A number of treatments may be useful including physiotherapy and exercise. While surgery can remove fat tissue it can also damage lymphatic vessels. Treatment does not typically result in complete resolution. It is estimated to affect up to 11% of women. Onset is typically during puberty, pregnancy, or menopause.

Milroy's disease (MD) is a familial disease characterized by lymphedema, commonly in the legs, caused by congenital abnormalities in the lymphatic system. Disruption of the normal drainage of lymph leads to fluid accumulation and hypertrophy of soft tissues. It is also known as Milroy disease, Nonne-Milroy-Meige syndrome and hereditary lymphedema.

It was named by Sir William Osler for William Milroy, a Canadian physician, who described a case in 1892, though it was first described by Rudolf Virchow in 1863.

Lymphedema praecox is a condition characterized by swelling of the soft tissues in which an excessive amount of lymph has accumulated, and generally develops in females between the ages of nine and twenty-five.This is the most common form of primary lymphedema, accounting for about 80% of the patients.