Sheeza Basharatover 1 year ago

Elephantiasis Nostras Verrucosa

A 68 year old female. Only history is hypothyroidism. It exists for 17 years. It's a case of “Elephantiasis Nostras Verrucosa”, A rare form of chronic lymphedema that causes progressive cutaneous hypertrophy. It can lead to severe disfiguration of body parts with gravity-dependent blood flow, especially the lower extremities. Various factors can cause obstruction of the lymphatic system and result in ENV. Clinically, ENV is characterized by non-pitting edema and superimposed hyperkeratotic papulonodules with a verrucose or cobblestone-like appearance. (Early-stage lesions might exhibit pitting edema; late-stage lesions exhibit nonpitting edema.) It needs to be differentiated from pretibial myxedema, filariasis, lipedema, chromoblastomycosis, lipodermatosclerosis, and venous stasis dermatitis.