Inflammatory lymphedema
Bilateral lower extremity inflammatory lymphedema (BLEIL) is a distinct type of lymphedema occurring in a setting of acute and prolonged standing, such as in new recruits during basic training. The possible underlying mechanisms are thought to be venous congestion and inflammatory vasculitis. Physiology
Lymph is formed from the fluid that filters out of the blood circulation and contains proteins, cellular debris, bacteria, etc. The collection of this fluid is carried out by the initial lymph collectors that are blind-ended endothelial-lined vessels with fenestrated openings that allow fluids and particles as large as cells to enter. Once inside the lumen of the lymphatic vessels, the fluid is guided along increasingly larger vessels, first with rudimentary valves to prevent backflow, which later develops into complete valves similar to the venous valve. Once the lymph enters the fully valved lymphatic vessels, it is pumped by a rhythmic peristaltic-like action by smooth muscle cells within the lymphatic vessel walls. This peristaltic action is the primary driving force, moving lymph within its vessel walls. The regulation of the frequency and power of contraction is regulated by the sympathetic nervous system. Lymph movement can be influenced by the pressure of nearby muscle contraction, arterial pulse pressure and the vacuum created in the chest cavity during respiration, but these passive forces contribute only a minor percentage of lymph transport. The fluids collected are pumped into continually larger vessels and through lymph nodes, which remove debris and police the fluid for dangerous microbes.
Streptococcal intertrigo is a skin condition that is secondary to a streptococcal bacterial infection. It is often seen in infants and young children and can be characterized by a fiery-red color of the skin, foul odor with an absence of satellite lesions, and skin softening (due to moisture) in the neck, armpits or folds of the groin. : 262  Newborn children and infants commonly develop intertrigo because of physical features such as deep skin folds, short neck, and flexed posture. Prompt diagnosis by a medical professional and treatment with topical and/or oral antibiotics can effectively relieve symptoms. Etiology
The main causes of intertrigo are mechanical factors, such as heat and maceration of the skin, and secondary infections, which mostly happens due to moisture build-up in the skin folds, making those areas ideal feeding places for secondary bacterial and fungal infections. A lot of cases of this disease are seen in individuals with diabetes mellitus since they have higher pH levels in their skin folds because of their condition. Given these reasons mentioned above, there have been higher cases of intertrigo in individuals with obesity, diabetes mellitus, immunodeficiency secondary to virus infection, large skin folds, are bedridden, or wear diapers that trap moisture (i.e. babies or older adults using incontinence supplies). Signs and symptoms
Streptococcal intertrigo commonly presents with a beefy-red, smooth, shiny lesion that has well-defined borders. There are no satellite lesions surrounding the area, and a distinct foul smell is common. The infection may be accompanied by general malaise and a low-grade fever.