Non-Filarial Elephantiasis, a Case Report with Review of the Literature
Published on: 2018-06-25
A 67 year old male presented to the wound clinic for evaluation of non-healing ulcers and massive edema of the lower extremities. He was an obese male with a history of quadriplegia secondary to septic embolus to the spinal cord. His course had been complicated by recurrent episodes of sepsis, including urosepsis. He routinely followed up at wound clinic for his lower extremity edema and recalcitrant ulcers over a period of years. Five years after his initial spinal cord injury, verrucous plaques began to develop on his inner thighs. The lesions demonstrated a fine scale and were darker than the surrounding tissue. They began as plaques bilaterally and spread slowly over time with formation of satellite lesions followed by coalescence. These lesions appeared to favor areas with prolonged exposure to moisture - remaining on the inner thighs bilaterally and extending to the groin. The primary treatment strategy was moisture reduction with wicking pads changed daily. The lesions did not respond to therapy, and recalcitrant ulcers and osteomyelitis of the left lower leg eventually led to a left above the knee amputation. This did lead to improvement in the verrucous lesions with a moderate reduction in the size of the lesions - presumably related to improved dryness of the area.