Elephantiasis nostras verrucosa: an institutional analysis of 21 cases
| Autor: | Steven M Dean, Matthew J. Zirwas, Anthony Vander Horst |
|---|---|
| Rok vydání: | 2009 |
| Předmět: |
Adult
Male medicine.medical_specialty Chronic venous insufficiency Dermatitis Dermatology Elephantiasis Comorbidity Gastroenterology Body Mass Index Scleroderma Localized Internal medicine Skin Ulcer medicine Humans Obesity Risk factor Aged Retrospective Studies business.industry Soft Tissue Infections Retrospective cohort study Middle Aged medicine.disease Surgery Obesity Morbid Lymphedema Lymphangitis Venous Insufficiency Cellulitis Chronic Disease Female business Body mass index |
| Zdroj: | Journal of the American Academy of Dermatology. 64(6) |
| ISSN: | 1097-6787 |
| Popis: | Previous reports regarding elephantiasis nostras verrucosa (ENV) have been typically limited to 3 or fewer patients.We sought to statistically ascertain what demographic features and clinical variables are associated with ENV.A retrospective chart review of 21 patients with ENV from 2006 to 2008 was performed and statistically analyzed.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).The statistical conclusions were potentially inhibited by the relatively small cohort. The study was retrospective.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. |
| Databáze: | OpenAIRE |
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