Certified Wound Ostomy Nurse (CWON) Practice Test

What type of edema is characterized as non-pitting and has a "cobblestone" texture?

1. Acute lymphedema

2. Spontaneously irreversible lymphedema

3. Reversible lymphedema

4. Mixed lymphedema

The correct answer is: Spontaneously irreversible lymphedema

The type of edema characterized as non-pitting and having a "cobblestone" texture is indeed spontaneously irreversible lymphedema. This form of lymphedema results from chronic lymphatic obstruction, which leads to significant fluid accumulation and tissue changes over time. In spontaneously irreversible lymphedema, fibrosis and fat deposition occur, resulting in a firm, “cobblestone” appearance to the skin and a lack of pitting upon pressure. This texture reflects the underlying pathological changes that have taken place due to prolonged lymphedema. The formation of fibrosis impairs the return of interstitial fluid and alters the skin and subcutaneous tissue architecture, contributing to the pronounced physical characteristics observed in this condition. In contrast, other types of lymphedema, such as acute lymphedema or reversible lymphedema, typically present with pitting qualities due to more fluid accumulation without the chronic tissue changes, thus lack the "cobblestone" texture.