Elephantiasis nostras verrucosa

Abstract

Elephantiasis nostras verrucosa (ENV) is the progressive disfiguring enlargement of a body part. It results from blockage of cutaneous lymphatic drainage systems. The causes induce ENV including mycotic, syphilitic, tuberculoid infection, neoplasms, and trauma. Clinical manifestation includes hyperkeratosis, lichenification, dermal fibrosis with verrucous papules and nodules which gives a cobblestone-appearance. The lower extremities are the most commonly affected sites. Many conditions such as chromoblastomycosis, lipedema, lipodermatosclerosis could be confused with ENV. Because this is a progressive condition which might cause disability and deformity, early diagnosis and treatment is needed to avoid the complication. Management of ENV is often challenging and often bases on the clinical experience. Medical and surgical therapies have a variety successful outcome but further reliable goal standard treatment should be investigated in the future.