DOI: 10.36347/sasjm.2023.v09i01.009

Pages: 40-46

Introduction: Ankylosing spondylitis or rheumatic pelvispondylitis is a chronic inflammatory rheumatism characterized by an axial localization predominantly in the spine and sacroiliac joints, an involvement of the entheses and a tendency to bone ankylosis by ossification of these entheses. We report an observation of right lower limb lymphedema associated with ankylosing spondylitis. Observation: This was a 63-year-old patient with a history of inflammatory rheumatism (his older sister) and osteoporosis (his mother), He was diagnosed with ankylosing spondylitis based on enthesis involvement (bilateral tilted gluteal pain and low inflammatory back pain) with a positive HLA-B27 antigen by the 8-point Amor criteria for spondyloarthritis (right unilateral sacroiliitis, low inflammatory back pain, bilateral tilted gluteal pain, HLA-B27+ and NSAID sensitivity). The unilateral lymphedema with positive Stemmer's sign affected the lower 2/3 of the right lower limb. It occurred one year after the onset of ankylosing spondylitis. The echo-Doppler scan showed no signs of thrombosis or venous infiltration of the lower limbs, and diffuse infiltration of the subcutaneous tissue of the right leg without inflammatory character. Treatment of ankylosing spondylitis gradually improved the lymphedema. Conclusion: Lymphedema is a rare complication of ankylosing spondylitis. Dermatologists should be alert to early swelling of the extremities in patients with ankylosing spondylitis so as not to delay specific multidisciplinary treatment and measures to avoid irreversible lymphatic damage.