{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T19:16:24Z","timestamp":1777922184968,"version":"3.51.4"},"reference-count":27,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2022,8,1]],"date-time":"2022-08-01T00:00:00Z","timestamp":1659312000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Lymphatic Research and Biology"],"published-print":{"date-parts":[[2022,8,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Recurrent cellulitis has high impact on physical, psychological, and social aspects for lymphedema patients. We speculated that identification of characteristics of skin and subcutaneous adipose tissue with cellulitis history can help considering new approach for prevention of recurrent cellulitis in lymphedema patients. Therefore, in this study, we aimed to noninvasively identify the ultrasonographic features of skin and subcutaneous tissue of lymphedema in patients with a cellulitis history.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and Results:<\/jats:title>\n                    <jats:p>\n                      This was a cross-sectional study, and all data were collected from patients' medical records. We assessed ultrasonographic images of the lower extremity of patients with lymphedema that were obtained in a lymphedema clinic. The ultrasonographic images were analyzed on the basis of the following five features: dermal hypoechogenicity, unclear dermal border, unclear superficial fascia, increased subcutaneous echogenicity, and subcutaneous cobblestone appearance. Fifty-two ultrasonographic images from 19 female patients with lower extremity lymphedema, including 8 with and 11 without a cellulitis history, were analyzed. The proportion of dermal hypoechogenicity on the upper leg was significantly higher in the patients with than in those without a cellulitis history (75.0% vs. 9.1%,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.006).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Cellulitis history in lymphedema patients appears to be associated with dermal hypoechogenicity, particularly in the proximal lower extremity. This finding suggests that it may be the initial step to consider new approach for prevention of recurrent cellulitis in lymphedema patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1089\/lrb.2021.0004","type":"journal-article","created":{"date-parts":[[2021,11,11]],"date-time":"2021-11-11T14:44:46Z","timestamp":1636641886000},"page":"376-381","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":2,"title":["Association of Dermal Hypoechogenicity and Cellulitis History in Patients with Lower Extremity Lymphedema: A Cross-Sectional Observational Study"],"prefix":"10.1177","volume":"20","author":[{"given":"Misako","family":"Dai","sequence":"first","affiliation":[{"name":"Department of Skincare Science, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan."},{"name":"Research Center for Implementation Nursing Science Initiative, School of Health Sciences, Fujita Health University, Aich, Japan."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takeo","family":"Minematsu","sequence":"additional","affiliation":[{"name":"Department of Skincare Science, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan."},{"name":"Division of Care Innovation, Global Nursing Research Center, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yoshihiro","family":"Ogawa","sequence":"additional","affiliation":[{"name":"Limbs Tokushima Clinic, Tokushima, Japan."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Atsuo","family":"Kawamoto","sequence":"additional","affiliation":[{"name":"Division of Ultrasound, Department of Diagnostic Imaging, Tokyo Medical University Hospital, Tokyo, Japan."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gojiro","family":"Nakagami","sequence":"additional","affiliation":[{"name":"Division of Care Innovation, Global Nursing Research Center, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan."},{"name":"Department of Gerontological Nursing\/Wound Care Management, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hiromi","family":"Sanada","sequence":"additional","affiliation":[{"name":"Division of Care Innovation, Global Nursing Research Center, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan."},{"name":"Department of Gerontological Nursing\/Wound Care Management, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2022,8,22]]},"reference":[{"key":"e_1_3_4_2_2","first-page":"170","article-title":"The diagnosis and treatment of peripheral lymphedema: 2016 consensus document of the International Society of Lymphology","volume":"49","author":"International Society of Lymphology Consensus Document of Congress XVII","year":"2017","unstructured":"International Society of Lymphology Consensus Document of Congress XVII. The diagnosis and treatment of peripheral lymphedema: 2016 consensus document of the International Society of Lymphology. Acta Angiol, 2017; 49:170\u2013184.","journal-title":"Acta Angiol"},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.5535\/arm.2016.40.2.326"},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.avsg.2015.01.037"},{"key":"e_1_3_4_5_2","first-page":"38","article-title":"Cellulitis and Lymphoedema: A vicious cycle","volume":"4","author":"AI-Niaimi F","year":"2009","unstructured":"AI-Niaimi F, , Cox N. Cellulitis and Lymphoedema: A vicious cycle. 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