Stasis Papillomatosis Clinical Features, Etiopathogenesis and Radiological Findings

Abstract

Stasis papillomatosis can be divided into localized and widespread forms. Ten patients with this disease are discussed with emphasis on their clinical and lymphoradiological findings. Using isotope lymphography we were able to find an overall lymphostasis in only four patients. In all patients, local lymphatic disturbances were detected by means of indirect lymphography with intradermal lymph cysts as the most specific sign. Local dermal lymphostasis seems to be the common final pathogenesis in spite of different etiologies (ie, primary lymphedema, chronic venous insufficiency, trauma recurrent erysipelas, and local lymphangiodysplasia of unknown origin). A maximum variant was seen, following en-bloc resection of subcutaneous tissue in a patient suffering from congenital lymphedema.

Localized lymphedema (elephantiasis): a case series and review of the literature

“…[4][5][6] Histopathologically, lymphedema is a fibroinflammatory process. 7,8 Typically, elephantiasis diffusely involves the body part affected by lymphedema (legs more than arms and genitalia episodically); 8 exceptionally, lymphedema involves circumscribed region of skin producing a solitary, large polyp, indurated (solid) plaque, papillomatous plaque, [69][70][71][72][73][74][75][76][77][78][79][80] pendulous swelling [81][82][83][84][85][86][87][88][89][90] or large, sarcoma-like mass. Herein, we report the clinicopathologic findings of a consecutive series of 24 cases of localized lymphedema (elephantiasis) and review the literature on this phenomenon.…”

A Case of Stasis Papillomatosis Associated with Psoriasis Vulgaris

“…Local lymphatic disturbances were detected by means of indirect lymphography. Similarly, in the present case, direct lymphography failed to reveal any abnormalities, but intracutaneous injection of the water-soluble contrast medium demonstrated characteristic abnormal findings (1,(5)(6)(7).…”

“…Zouboulis (4) suggested that functional incapacity of lymphatics, which are the major escape routes for excess proteins and fluids in tissues, causes a high interstitial protein concentration, causing fluid to be retained in tissues as a result of osmotic forces and resulting in chronic inflammatory changes with fibrosis and epidermal hyperplasia. One of the etiologies reported for this condition is chronic bacterial infection (1)(2)(3). Although the erosions on the left lower leg in our patient might have been caused by cutaneous bacterial infection three months prior to his admission, similar papillomatous lesions were noted on the right lower leg after the thick scales were removed.…”

“…Papillomatous skin lesions occasionally develop as a result of congestion oflymphatics or veins (1)(2)(3). There are different designations for these lesions, including elephantiasis nostras, elephantiasis verrucosa, elephantiasis crurum papillaris et venucosa, lymphostatic papillomatosis cutis, lymphostatic verrucosis, papillomatosis cutis venucosa, pachydermia vegetans, and mossy foot and leg (4).…”

“…There are different designations for these lesions, including elephantiasis nostras, elephantiasis verrucosa, elephantiasis crurum papillaris et venucosa, lymphostatic papillomatosis cutis, lymphostatic verrucosis, papillomatosis cutis venucosa, pachydermia vegetans, and mossy foot and leg (4). In 1993, ten cases of this condition with different origins were reported as stasis papillomatosis (1). Although local lymphatic disturbances were detected in all these ten cases by indirect lymphography, three of them showed no overall lymphostasis or chronic venous insufficiency.…”