Lymphoedema or cellulitis? That is the question....

The accurate diagnosis of cellulitis is a particularly topical subject; a recent systematic review published in the British Journal of Dermatology (BJD)1 found that 31% of patients admitted from emergency departments with suspected lower-limb cellulitis were misdiagnosed. This subsequently resulted in unnecessary patient morbidity, hospital admission, antibiotics and health care spending1 . The researchers identified a key research gap in the diagnosis of lower limb cellulitis and highlighted the lack of robust and validated diagnostic criteria or tools for primary and secondary care. The importance for clear diagnostic criteria was also reflected in the 2017 Priority Setting Partnership² .

We present a real-life clinical scenario to discuss key learning points for diagnosing and managing lower limb cellulitis and one of its mimics: lymphoedema. Taken together, both our case and the BJD systematic review highlight the clinical need for the development of a validated method of identifying lower limb cellulitis.