Elephantiasis nostras verrucosa
Alerts and Notices
Important News & Links
Synopsis

Elephantiasis nostras verrucosa (ENV) is a somewhat rare complication of nonfilarial chronic lymphedema that arises from a variety of obstructive diseases of the lymphatic system. The blocked lymphatic channels lead to protein-rich fluid in the dermis and subcutaneous tissues and brawny edema. The subsequent changes of ENV consist of increased girth of the affected body part (usually the lower limb), woody induration, and cutaneous changes, including hyperkeratosis, a cobblestone or papillated appearance, and verrucous papules.
Causes of nonfilarial chronic lymphedema include conditions that block lymphatic drainage: congestive heart failure, deep vein thrombosis, morbid obesity, recurrent staphylococcal or streptococcal infections, malignancies (such as lymphoma), and prior surgery or trauma.
ENV is a progressive condition that, left untreated, results in ongoing deformity and disability. Complications include lymphorrhea, infection, secondary ulceration, and poor wound healing.
Causes of nonfilarial chronic lymphedema include conditions that block lymphatic drainage: congestive heart failure, deep vein thrombosis, morbid obesity, recurrent staphylococcal or streptococcal infections, malignancies (such as lymphoma), and prior surgery or trauma.
ENV is a progressive condition that, left untreated, results in ongoing deformity and disability. Complications include lymphorrhea, infection, secondary ulceration, and poor wound healing.
Codes
ICD10CM:
I89.0 – Lymphedema, not elsewhere classified
SNOMEDCT:
61624008 – Elephantiasis nostras
I89.0 – Lymphedema, not elsewhere classified
SNOMEDCT:
61624008 – Elephantiasis nostras
Look For
Subscription Required
Diagnostic Pearls
Subscription Required
Differential Diagnosis & Pitfalls
- Venous stasis dermatitis
- Lipodermatosclerosis
- Pretibial myxedema – Bilateral nodules or plaques are present on the pretibial area bilaterally.
- Lymphatic filariasis – Lymphedema is present in lower limbs and possibly genitals and is accompanied by history of foreign travel. It is secondary to infection with filarial worms (filariasis), Wucheria bancrofti, Brugia malayi, and Brugia timori, all of which are transmitted by a mosquito bite.
- Lymphangioma circumscriptum
- Acquired lymphangiectasia
- Tuberculous lymphangitis (see tuberculosis)
- Cellulitis
- Deep venous thrombosis
- Lipedema
- Podoconiosis
- Mycetoma
- Kaposi sarcoma
- Stewart-Treves syndrome
- Chromoblastomycosis
Best Tests
Subscription Required
Management Pearls
Subscription Required
Therapy
Subscription Required
References
Subscription Required
Last Reviewed:11/12/2020
Last Updated:11/12/2020
Last Updated:11/12/2020