Elephantiasis nostras verrucosa as a manifestation of morbid obesity

Pérez-Rodríguez, Irma Margarita; Ocampo‐Garza, Jorge; Garza-Chapa, Juana Irma; Ocampo‐Candiani, Jorge

doi:10.1136/bcr-2014-207574

Cited by 4 publications

(4 citation statements)

References 2 publications

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“…We conducted searches in PubMed (using the search terms elephantiasis nostras verrucosa, lymphedema, and obesity) to gather available data regarding ENV and its historical management. Our literature review of ENV case reports elucidated Class III obesity as a common denominator in all cases [2][3][4][5][6][7][9][10][11][12][13][14]. As such, the mainstay of treatment in ENV involves wound care, compression therapy, and weight loss [8].…”

Section: Evaluation and Diagnosismentioning

confidence: 99%

Disease Specific to Chronic Lymphedema and Class III Obesity

Figenshau

Lindquist

2020

Case Reports in Medicine

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Elephantiasis nostras verrucosa (ENV) is a unique, chronic condition found in patients with obesity and chronic secondary lymphedema. It develops due to chronic inflammation and recurrent infection, most commonly on gravity-dependent sites. Progressive tissue enlargement, deformity, and disability necessitate intervention. First, clinicians should explore the etiology of patients’ secondary lymphedema, as this is paramount in determining treatment for ENV. The fundamental goal is alleviating lymphatic obstruction. Our literature review of available cases of ENV elucidates Class III obesity as a factor common to all available cases of ENV. As such, weight loss is a key component of treatment. Medical management and weight loss are most effective when combined with physiologic interventions such as compression garments and decongestive physiotherapy. If surgical intervention is required, one of the mainstays of patient management is a reductive approach, aimed at removing excess adipose and fibrotic tissue to improve lymphatic patency and flow. Optimal postoperative outcomes are achieved when patients also undergo physiologic procedures to bypass obstructions and connect functioning lymphatic vessels.

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Section: Evaluation and Diagnosismentioning

confidence: 99%

Disease Specific to Chronic Lymphedema and Class III Obesity

Figenshau

Lindquist

2020

Case Reports in Medicine

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“…This is an unusual form of presentation of lymphedema in these patients and few descriptions are found in the literature. 2 The literature suggests episodes of sudden infection as the cause of this evolution. 3 We consider it important to report and document these cases, due to the limitation and the little information or availability of the same in the current scientific literature.…”

Section: Discussionmentioning

confidence: 99%

“…Repetitive or chronic infectious processes constitute the main hypothesis for this form of clinical evolution. 2,3 There is no single form of treatment for lymphedema, association of therapies is usually recommended. Manual and mechanical lymphatic drainage, lymphomyokinetic activities and exercises, compression garments and mechanisms are part of physical therapy, but social and psychological aspects could be considered.…”

Section: Introductionmentioning

confidence: 99%

Elephantiasis nostras verrucosa: case report

Godoy

2023

Int J Res Dermatol

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Lymphedema is a clinical condition in which an accumulation of macromolecules occurs in the interstitial space and an atypical evolution known as elephantiasis nostras verrucosa may occur. The objective of this study is to report on the clinical evolution and analysis of the progression of a 56-year-old patient with a diagnosis of primary bilateral stage II lymphoedema. With an atypical presentation of it, identified as elephantiasis nostra verrucosa. The patient had suffered from lymphoestatic edema since he was 10 years old, having previously received ineffective treatments until he arrived at the Clinica Godoy in Sao Jose de Rio Preto Brazil, where he underwent an intensive therapy procedure treatment model proposed by Godoy and Godoy; in which favorable results were obtained in a short period of time. Lymphedema is a chronic disease that is manageable but not curable. It is also difficult to be treated, especially if it has progressed to a late stage such as elephantiasis nostras verrucosa associated the continuous and repetitive infectious and inflammatory processes over time must have contributed to the evolution of the fibrotic pattern. Intensive treatment based on the Godoy method® is possible reduce in short period of time the volume and improve fibrosis and quality of life this patient.

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“…It most commonly affects one lower extremity, although cases affecting upper extremities have also been described 5. Regarding secondary lymphoedema, several causes may be involved, such as surgical damage to the lymphatic system (one of the most common causes in industrialised countries, especially related to tumorous treatment—namely breast cancer and melanoma, but also other gynaecological and genitourinary cancers), radiotherapy, infections such as filariasis (the most common cause of secondary lymphedema worldwide, frequently occurring in developing countries) or recurrent bacterial infections (specifically cellulitis), inflammatory conditions causing permanently damage the lymphatic system, morbid obesity, trauma, congestive heart failure, portal hypertension and, rarely, pretibial myxoedema 2 6. Venous diseases, such as varicose veins or deep vein thrombosis can also lead to lymphoedema, as damaged veins can cause fluid to overflow from the veins into the tissue spaces.…”

Section: Discussionmentioning

confidence: 99%

Elephantiasisnostras verrucosain the setting of lymphoedematardaand neurofibromatosis type 1

et al. 2019

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Elephantiasis nostras verrucosa (ENV) comprises an uncommon skin disease characterised by dermal fibrosis with hyperkeratotic, verrucous and papillomatous lesions that usually occur after chronic lymphoedema. We describe the case of a 56-year-old-man with neurofibromatosis type 1, no known surgical history, no chronic medication and no travel history, presenting with worsening non-pitting oedema and impressive foul-smelling mossy plaques and cobblestone-like nodules in both legs and feet, especially on the right, compatible with the diagnosis of ENV.

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Elephantiasis nostras verrucosa as a manifestation of morbid obesity

Cited by 4 publications

References 2 publications

Disease Specific to Chronic Lymphedema and Class III Obesity

Disease Specific to Chronic Lymphedema and Class III Obesity

Elephantiasis nostras verrucosa: case report

Elephantiasisnostras verrucosain the setting of lymphoedematardaand neurofibromatosis type 1

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