Rapid responses are electronic comments to the editor. They enable our users to debate issues raised in articles published on bmj.com. A rapid response is first posted online. If you need the URL (web address) of an individual response, simply click on the response headline and copy the URL from the browser window. A proportion of responses will, after editing, be published online and in the print journal as letters, which are indexed in PubMed. Rapid responses are not indexed in PubMed and they are not journal articles. The BMJ reserves the right to remove responses which are being wilfully misrepresented as published articles.
If infective lymphangitis is strictly defined as a distinct component from infective lymphadenitis, then it may be correct to suggest there is rarity: otherwise, no.
Lymphadenitis complicating infections particularly in the lower limbs is very common and could not be without some element of associated lymphatic inflammation via which the pathogens must need access the lymph glands as an anatomic precondition.
However, such lymphangitic precondition may be subclinical, presenting with none of the dermal changes observed in classical infective lymphangitis, beyond some tenderness in the groin (inguinal adenitis) or similar nodal substations.
It is also relevant to mention that the redness of the lymphangitis may be less typical the darker the natural skin color is and therefore tenderness along suspected lymphatic routes even in absence of clinical erythema should still raise a certain level of suspicion for lymphangitis.