In the summer, more and more patients come to the clinic to see swollen legs, saying that their legs are unbearably swollen, and when they press their calves with their hands, they have a pit. Many patients have been investigated in the internal medicine department, and no abnormalities have been found in laboratory tests, ultrasound, CT and MRI, but their legs keep swelling without any signs of relief. Why is it easy to have swollen legs in the summer? 1, why is easy to leg swelling in the summer leg swelling is excessive fluid accumulation in the human lower extremity tissue gap to swell near the neck of the foot, many internal diseases can cause leg swelling, but not much correlation with the season. The culprit of seasonal leg swelling in summer is a fungal infection. Many patients in this segment have fungal diseases such as tinea pedis, pediculosis, and gray toenails on their feet. Because of the summer heat and humidity, fungi tend to multiply and grow. Toe skin cracks, toenail crevices and toenail tips are common invasion pathways for pathogenic fungi, and fungal infections can cause lymphatic vessels to be blocked and lymphatic return flow to the lower extremities to be poor, resulting in leg swelling, which is more common seasonally and periodically. 2.What is lymphedema Fungal infection blocks the lymphatic vessels, the lymphatic return flow is obstructed resulting in increased pressure in the lymphatic vessels, the lymphatic vessels are distorted and dilated, resulting in the backflow of lymphatic fluid, which eventually affects the absorption of intertissue fluid and macromolecular substances by capillary lymphatic vessels, causing water and sodium retention in the subcutaneous space in the body and aggravating subcutaneous edema. Simply put, the leg swelling caused by fungal infection blocking lymphatic vessels is lower limb lymphedema. 3.What tests are available to confirm the diagnosis of “lymphedema”? Is there any other possible disease? The swollen lymphatic vessels cannot be seen by ultrasound, CT or MRI, so many people have had many tests, but their legs are swollen and they cannot find the root of the disease. At present, there is really no clear test that can confirm the diagnosis of lymphedema, and very few hospitals in China can carry out lymphography, which is mostly used for serious lymphatic diseases such as filariasis and elephantiasis, and is used to diagnose lymphedema of the lower extremities with the meaning of anti-aircraft guns hitting mosquitoes. Lower extremity lymphedema is a diagnosis made by a professional vascular surgeon based on the patient’s history, symptoms and physical examination and clinical experience, and is usually a diagnosis of exclusion. The premise of the diagnosis is to combine the history of fungal infections such as gray toenails, pediculosis and tinea pedis in the feet and to exclude some medical diseases with leg swelling symptoms, which can be considered from the following aspects. A look at whether chronic kidney disease with facial swelling is considered to be of nephrogenic origin. Generally do a urine routine is enough to see if there is urine protein, there is urine protein that kidney must have problems, need to see nephrology. The second look at whether there is a heart problem, most patients with heart disease have a history of chronic disease for many years, may be taking related drugs for a long time, you can do cardiac ultrasound examination clearly. Third, see if there is liver disease, poor liver function can also cause hypoproteinemia, resulting in swelling, check whether the sclera is yellow, whether the skin is yellow, and draw blood to check the liver function. Four to see if there are endocrine diseases, such as hypothyroidism, this can be done by taking blood to check the A function, T4 is reduced while T3 is normal can be considered as one of the indicators of early diagnosis of hypothyroidism. Fifthly, we need to see if there is thrombosis on the leg, one leg is swollen and the other leg is normal, this is more often seen in venous thrombotic disease, which has a certain risk, so we suggest to consult the vascular surgery. Deep vein thrombosis is usually sudden swelling with pain, and there is a risk of death from thrombosis and pulmonary embolism, so a deep vein ultrasound of the lower extremities can be prescribed at the vascular surgery department to confirm the diagnosis. Six to see whether drug leg swelling. Many people have hypertension, taking antihypertensive drugs such as calcium antagonists, nifedipine extended-release tablets, etc. will cause leg swelling, which is generally not serious and will be reduced after the body adapts, but if it continues to not ease, you can consider replacing the drug. There are many causes of leg swelling, which can be a symptom of systemic diseases or one of the symptoms of local diseases of the lower limbs, so it is necessary to go to the hospital for examination to identify the cause of the disease so that reasonable treatment can be carried out. 4.What are the ways to prevent lower limb lymphedema? For the prevention of leg swelling, the following measures can be taken to prevent and treat it. The human body normally has a mechanism to resist the invasion of external bacteria and fungi, but when the immune system is low, it is easy to get bacterial and fungal infections, which is commonly known as “low resistance” and is related to staying up late, fire, lack of sleep and insufficient rest. Therefore, ensure good sleep and regular living. Keep optimistic mood, adhere to appropriate exercise, such as walking, jogging, fitness equipment exercise, in order to enhance physical fitness, improve the ability to adapt. Some patients have special hygiene, like to cut toenails frequently. Toenail cut too short is not good, because the human toenail is a protective role, can prevent fungal invasion, and toenail cut too short will cause the loss of the protective barrier, fungus easily invade the body. Generally stay 1-2mm more appropriate. Choose loose and breathable shoes, the standard is not to cover the feet. Choose vitamin-rich foods, moderate amounts of protein and calcium, and recommend drinking milk. You can eat more celery, tomatoes, mushrooms, fruits and soy products. Avoid drinking excessive amounts of water before going to bed. In summer, you can eat some diuretic foods, such as watermelon, green beans, winter melon, etc., to discharge the excess water stagnant in your body, and exercise your legs a little after waking up, the swelling of your legs can be reduced. 5.How to treat lymphedema? We should pay attention to diet and life conditioning, supplement protein in appropriate amount, strengthen sports and exercise, and wear shoes and socks with appropriate elasticity to prevent skin damage. When the swelling is serious, these drugs can be taken and should be applied reasonably under the guidance of a doctor. The following drugs are used to reduce local edema. Horse chestnut seed extract such as Mai Zhi Ling; flavonoids, hesperidin such as Diosmin; and chemotherapeutic drugs including calcium hydroxybenzoate. Other botanical ingredients such as herbaceous rhizome infusion tablets abortifacient-M tablets. The use of intravenous active drugs is based on the principle of increasing venous tone and capillary permeability, and flavonoids can reduce inflammation and edema by affecting leukocytes and epithelial cells. Horse chestnut seed extract (hesperidin) is effective in reducing edema, pain and itching. Diosmin, hesperidin, and micronized purified flavonoids may reduce painful spasms. Topical ketoconazole ointment can be used for fungal infections of the foot.