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Elephantiasis nostras verrucosa
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Elephantiasis nostras verrucosa

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Contributors: Noah Craft MD, PhD, Belinda Tan MD, PhD, Lindy P. Fox MD
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Synopsis

Elephantiasis nostras verrucosa is a somewhat rare complication of chronic obstructive lymphedema arising from a variety of obstructive diseases of the lymphatic system. Long-standing obstruction of the major lymphatic vessels is manifested by gross enlargement of the affected body part, usually the lower limbs. In addition, skin changes such as coarsening, corrugation, and fissuring are present.

Repetitive streptococcal infections are thought to be a factor in the pathogenesis of elephantiasis nostras verrucosa. A more significant cause is obesity. Lymphedema of obesity is simply due to poor lymphatic return. The massive increase of tissue in obese people acts as an impediment to lymphatic drainage, which is already compromised due to decreased muscular activity and peripheral vascular disease. These effects are further compounded by bacterial lymphangitis.

Elephantiasis nostras verrucosa is a progressive condition that, left untreated, results in ongoing deformity and disability. Complications include swelling, lymphorrhea, infection, and poor wound healing.

This condition should not be confused with elephantiasis secondary to parasitic infection with filarial worms (filariasis), Wucheria bancrofti, Brugia malayi, and Brugia timori, all of which are transmitted by a mosquito bite. A history of travel to Southeast Asia or Sub-Saharan Africa should indicate lymphatic filariasis.

Codes

ICD10CM:
I89.0 – Lymphedema, not elsewhere classified

SNOMEDCT:
61624008 – Elephantiasis nostras

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Last Updated: 10/05/2018
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Elephantiasis nostras verrucosa
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Elephantiasis nostras verrucosa : Lower extremity edema, Thick scaly plaque, Thickened skin, Warty, Foot or toes, Foot edema
Clinical image of Elephantiasis nostras verrucosa
Marked lymphedema of the foot with multiple shiny pink papules and brown spicules over the toes.

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