Risk factors for cellulitis in chronic leg edema include wounds, obesity, and midline swelling, while controlled swelling correlates with reduced risk, according to a study published in the July issue of the British Journal of Dermatology.

Ewa A. Burian, M.D., from Bispebjerg Hospital in Copenhagen, Denmark, and colleagues examined the prevalence of and risk factors for cellulitis in chronic leg edema in a cross-sectional study involving 40 sites in nine countries during 2014 to 2017. Data were included for 7,477 adults with clinically proven unilateral or bilateral chronic edema (for more than three months) of the lower leg.

The researchers found that 15.78 percent of the patients had cellulitis within the previous 12 months, with a lifetime prevalence of 37.47 percent. In a multivariable analysis, the investigators identified wounds, morbid obesity, obesity, midline swelling, male sex, and diabetes as risk factors for cellulitis (odds ratios, 2.37, 1.51, 1.21, 1.32, 1.32, and 1.27, respectively). There was an association noted for controlled swelling with reduced risk (odds ratio, 0.59). The risk increased with stage of edema in a subgroup analysis (International Society of Lymphology stage II and stage III: odds ratios, 2.04 and 4.88, respectively).

"This study adds epidemiological evidence of what has been known anecdotally for a long time: that edema control is associated with a lower risk of cellulitis," the authors write. "Prevention of deterioration of the edema may have a significant effect on reducing the risk of cellulitis, and thereby reducing health care costs."

Several authors disclosed financial ties to the biopharmaceutical and medical device industries; 3M Healthcare provided funding for the study.

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