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Pathology of "Elephant" iasis

    Dr Sampurna Roy MD

                                                                                                   

 

 

Elephantiasis is characterized by the thickening of the skin and underlying tissues, especially in the legs, male genitals and female breasts.

It is thought to develop as the result of chronic lymphedema.

 

1) Elephantiasis tropica or lymphatic filariasis:  

- Caused by a number of parasitic worms, particularly Wuchereria bancrofti.

Read: Pathology of Filariasis

2) Elephantiasis nostras verrucosa : 

- Related to chronic nonfilarial lymphedema caused by bacterial or noninfectious lymphatic obstruction.

- Presents as a grossly enlarged  lower extremities and feet, with a cobblestone or mossy appearance.

- Histological findings: Pseudoepitheliomatous hyperplasia, dilated lymphatic channels, widened tissue spaces, and extensive fibrous tissue hyperplasia within the dermis, subcutaneous tissue, and lymphatic vessel walls.

- Differential diagnosis :  Lymphatic filariasis, chromoblastomycosis, lipedema, lipodermatosclerosis, papillomatosis cutis carcinoides, popular mucinosis, pretibial myxedema, and Stewart Treves syndrome.

- Biopsy is necessary to rule out associated malignancy. 

3) Podoconiosis:

- It is a type of lower limb tropical elephantiasis distinct from lymphatic filariasis.

- Podoconiosis predominantly affects barefoot farmers in areas with red volcanic soil.

- Ethiopia is one of the countries with the highest number of podoconiosis patients since many people are at risk to red-clay soil exposure in many parts of the country.

4) "Elephant man" (Proteus syndrome)

In 1884 Joseph Merrick, the Elephant Man, presented with a rare disease. According to recent clinical diagnostic criteria he was suffering from Proteus syndrome.

Proteus syndrome is an extremely rare genetic condition


Interesting articles:

A note from History Elephantiasis

Clinical and historical aspects of the Elephant Man: exploring the facts and the myths.

Epidemiology of elephantiasis with special emphasis on podoconiosis in Ethiopia: A literature review.

Elephantiasis nostras verrucosa.

 

 

 

Dr Sampurna Roy  MD

Consultant  Histopathologist (Kolkata - India)

 

 


                                                                                                                                              

 

 

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