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Case report
Elephantiasis nostras verrucosa in the setting of lymphoedema tarda and neurofibromatosis type 1
  1. Joana Calvão1,
  2. Luís Santiago1,
  3. Maria Manuel Brites1 and
  4. Américo Figueiredo1,2
  1. 1Dermatology Department, Coimbra Hospital and University Centre, Coimbra, Portugal
  2. 2Faculty of Medicine, University of Coimbra, Coimbra, Portugal
  1. Correspondence to Dr Joana Calvão; joana.calvao.silva{at}


Elephantiasis nostras verrucosa (ENV) comprises an uncommon skin disease characterised by dermal fibrosis with hyperkeratotic, verrucous and papillomatous lesions that usually occur after chronic lymphoedema. We describe the case of a 56-year-old-man with neurofibromatosis type 1, no known surgical history, no chronic medication and no travel history, presenting with worsening non-pitting oedema and impressive foul-smelling mossy plaques and cobblestone-like nodules in both legs and feet, especially on the right, compatible with the diagnosis of ENV.

  • dermatology
  • skin
  • medical management

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  • Contributors JC (first author): acquisition and analysis of data, planning, conducting, conception and design of the article, as well as revision and final approval. LS: acquisition of data, revision and final approval. MMB: acquisition of data, final approval. AF: final approval.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.