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Retinoids in Other Skin Diseases
Published in Ayse Serap Karadag, Berna Aksoy, Lawrence Charles Parish, Retinoids in Dermatology, 2019
Uwe Wollina, Piotr Brzezinski, André Koch
Elephantiasis nostras is an end-stage lymphatic disorder characterized by chronic inflammation and disturbed lymphatic flow leading to fibrosis, papillomatosis, and sometimes verrucous skin lesions. A nearly complete resolution of verrucous elephantiasis nostras has been reported in a 64-year-old man during acitretin therapy (35).
Vascular tumors
Published in Eckart Haneke, Histopathology of the NailOnychopathology, 2017
Lymphangioma circumscriptum is a fairly common developmental anomaly involving the deep muscular lymph collectors.12 This leads to dilatation of the superficial lymph capillaries clinically simulating frog spawn. Bleeding into the lymphangioma may occur; however, it is one of the functions of lymph vessels to take up extravasated erythrocytes and to reintroduce them into the circulation. Thus, the term “hemangiolymphangioma” is not correct and the term “hematolymphangioma” is probably also unnecessary. Involvement of the tip of the digit is rare, but may lead to nail deformation or even gross enlargement of the digit. Superficial lacerations are common and may lead to recurrent erysipelas finally ending up in elephantiasis nostras. Therapeutically, “circumscribed” lymphangiomas are difficult to extirpate as their limits in the tissue are usually very ill-defined and the underlying malformation of the large lymph collectors may be missed or impossible to remove.
Elephantiasis in a patient with thyroid eye disease
Published in Orbit, 2022
Darius D. Bordbar, Ann Q. Tran, Andrea A. Tooley, Michael Kazim
A 29-year-old man with Graves disease presented with a 6-month history of bulging eyes and upper and lower extremity skin changes. The patient previously underwent radioactive iodine ablation and at the time of presentation was receiving levothyroxine and was euthyroid. There was no family history of Graves disease or thyroid eye disease (TED) and the patient was a non-smoker. Visual acuity was 20/20 bilaterally. There was no afferent pupillary defect. Ocular motility was moderately impaired in depression and abduction on the right and in elevation and abduction on the left. There was bilateral proptosis and upper and lower eyelid retraction with superior and inferior scleral show (Figure 1a). A computed tomography scan of the orbits demonstrated significantly enlarged extra-ocular muscles in a fusiform pattern (Figure 1b). Humphrey visual field testing was within normal limits. The patient’s fingers were uniformly swollen (Figure 1c), and the patient’s feet demonstrated non-pitting edema and cobblestone-appearing hyperkeratotic papulonodules (Figure 1d). A diagnosis of TED with associated infiltrative dermopathy producing acropachy and elephantiasis nostras verrucosa was made. The patient was given one dose of intravenous methylprednisolone with minimal improvement. Elephantiasis is an extremely rare manifestation of dermopathy. Its presence along with acropachy is often associated with severe TED that may require systemic immunosuppression.