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Elephantiasis nostras verrucosa: An institutional analysis of 21 cases.
MedLine Citation:
PMID:  21440328     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: Previous reports regarding elephantiasis nostras verrucosa (ENV) have been typically limited to 3 or fewer patients. OBJECTIVES: We sought to statistically ascertain what demographic features and clinical variables are associated with ENV. METHODS: A retrospective chart review of 21 patients with ENV from 2006 to 2008 was performed and statistically analyzed. RESULTS: All 21 patients were obese (morbid obesity in 91%) with a mean body mass index of 55.8. The average maximal calf circumference was 63.7 cm. Concurrent chronic venous insufficiency was identified in 15 patients (71%). ENV was predominantly bilateral (86%) and typically involved the calves (81%). Proximal cutaneous involvement (thighs 19%/abdomen 9.5%) was less common. Eighteen (86%) related a history of lower extremity cellulitis/lymphangitis and/or manifested soft-tissue infection upon presentation. Multisegmental ENV was statistically more likely in setting of a higher body mass index (P = .02), larger calf circumference (P = .01), multiple lymphedema risk factors (P = .05), ulcerations (P < .001), and nodules (P < .001). Calf circumference was significantly and proportionally linked to developing lower extremity ulcerations (P = .02). Ulcerations and nodules were significantly prone to occur concomitantly (P = .05). Nodules appeared more likely to exist in the presence of a higher body mass index (P = .06) and multiple lymphedema risk factors (P = .06). LIMITATIONS: The statistical conclusions were potentially inhibited by the relatively small cohort. The study was retrospective. CONCLUSIONS: Our data confirm the association among obesity, soft-tissue infection, and ENV. Chronic venous insufficiency may be an underappreciated risk factor in the genesis of ENV.
Authors:
Steven M Dean; Matthew J Zirwas; Anthony Vander Horst
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-3-24
Journal Detail:
Title:  Journal of the American Academy of Dermatology     Volume:  -     ISSN:  1097-6787     ISO Abbreviation:  -     Publication Date:  2011 Mar 
Date Detail:
Created Date:  2011-3-28     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7907132     Medline TA:  J Am Acad Dermatol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2010 American Academy of Dermatology, Inc. Published by Mosby, Inc. All rights reserved.
Affiliation:
Department of Cardiovascular Medicine, Ohio State University College of Medicine, Columbus, Ohio.
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