{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T20:10:01Z","timestamp":1756325401848,"version":"3.44.0"},"reference-count":10,"publisher":"BMJ","issue":"11","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2019,10,26]]},"published-print":{"date-parts":[[2019,11]]},"abstract":"<jats:p>Elephantiasis <jats:italic>nostras verrucosa<\/jats:italic> (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.<\/jats:p>","DOI":"10.1136\/bcr-2019-230637","type":"journal-article","created":{"date-parts":[[2019,11,11]],"date-time":"2019-11-11T06:15:42Z","timestamp":1573452942000},"page":"e230637","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Elephantiasis <i>nostras verrucosa<\/i> in the setting of lymphoedema <i>tarda<\/i> and neurofibromatosis type 1"],"prefix":"10.1136","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1161-269X","authenticated-orcid":false,"given":"Joana","family":"Calv\u00e3o","sequence":"first","affiliation":[{"name":"Dermatology Department, Coimbra Hospital and University Centre, Coimbra, Portugal"}]},{"given":"Lu\u00eds","family":"Santiago","sequence":"additional","affiliation":[{"name":"Dermatology Department, Coimbra Hospital and University Centre, Coimbra, Portugal"}]},{"given":"Maria Manuel","family":"Brites","sequence":"additional","affiliation":[{"name":"Dermatology Department, Coimbra Hospital and University Centre, Coimbra, Portugal"}]},{"given":"Am\u00e9rico","family":"Figueiredo","sequence":"additional","affiliation":[{"name":"Dermatology Department, Coimbra Hospital and University Centre, Coimbra, Portugal"},{"name":"Faculty of Medicine, University of Coimbra, Coimbra, Portugal"}]}],"member":"239","published-online":{"date-parts":[[2019,11,10]]},"reference":[{"key":"2025082712562253000_12.11.e230637.1","doi-asserted-by":"crossref","first-page":"611","DOI":"10.1177\/1203475418763548","article-title":"The successful treatment of elephantiasis nostras verrucosa with ablative carbon dioxide laser","volume":"22","author":"Robinson","year":"2018","journal-title":"J Cutan Med Surg"},{"key":"2025082712562253000_12.11.e230637.2","doi-asserted-by":"crossref","first-page":"579","DOI":"10.1111\/iwj.13050","article-title":"Acitretin may improve symptoms and exudation in patients affected by elephantiasis nostras verrucosa: report of a case","volume":"16","author":"Marasca","year":"2019","journal-title":"Int Wound J"},{"key":"2025082712562253000_12.11.e230637.3","doi-asserted-by":"crossref","unstructured":"Wang Q , Yang Y , Wu F , et al . Predominant T-helper 17 skewing in elephantiasis nostras verrucosa. J Dermatol 2019:1\u20132.","DOI":"10.1111\/1346-8138.14848"},{"key":"2025082712562253000_12.11.e230637.4","doi-asserted-by":"crossref","unstructured":"Garc\u00eda Peris E , Mart\u00edn-Neda F , Alvarez I , et al . Initial stage of elephantiasis nostras verrucosa in a 30 years lasting giant lymphedema. J Am Acad Dermatol 2014;70.","DOI":"10.1016\/j.jaad.2014.01.483"},{"key":"2025082712562253000_12.11.e230637.5","doi-asserted-by":"crossref","first-page":"345","DOI":"10.1016\/j.ejvs.2012.06.019","article-title":"Classification of lymphatic-system malformations in primary lymphoedema based on Mr lymphangiography","volume":"44","author":"Liu","year":"2012","journal-title":"Eur J Vasc Endovasc Surg"},{"key":"2025082712562253000_12.11.e230637.6","doi-asserted-by":"crossref","DOI":"10.1136\/bcr-2014-207574","article-title":"Elephantiasis nostras verrucosa as a manifestation of morbid obesity","volume":"2014","author":"P\u00e9rez-Rodr\u00edguez","year":"2014","journal-title":"BMJ Case Rep"},{"key":"2025082712562253000_12.11.e230637.7","doi-asserted-by":"crossref","first-page":"88","DOI":"10.1002\/jgf2.28","article-title":"Chronic unilateral leg swelling caused by iliac vein compression (Cockett's) syndrome in an elderly patient","volume":"18","author":"Sugawara","year":"2017","journal-title":"J Gen Fam Med"},{"key":"2025082712562253000_12.11.e230637.8","doi-asserted-by":"crossref","unstructured":"Freitas A , Rodrigues JFM . Elephantiasis nostras verrucosa secondary to recurrent erysipelas. BMJ Case Rep 2017;9 doi:10.1136\/bcr-2017-221014","DOI":"10.1136\/bcr-2017-221014"},{"key":"2025082712562253000_12.11.e230637.9","doi-asserted-by":"crossref","unstructured":"Santiago L , Coutinho I , Brites MM . A case of exuberant elephantiasis nostras verrucosa. Acta Med Port 2017;30.doi:10.20344\/amp.8363","DOI":"10.20344\/amp.8363"},{"key":"2025082712562253000_12.11.e230637.10","doi-asserted-by":"crossref","unstructured":"Eda Y , Arita Y , Ogasawara N , et al . Tolvaptan for the treatment of elephantiasis nostras verrucosa. Intern Med 2019. doi:doi:10.2169\/internalmedicine.2815-19. 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