Papillomatosis cutis lymphostatica: a sign of chronic edema

Mariem Daldoul,Badreddine Sriha,Taghrid Tlili,Mohamed Denguezli,Sana Mokni,Amina Aounallah,Colandane Belajouza

doi:10.7241/ourd.20212.16

Abstract

An obese 53-year-old male presented himself to our department with lymphedema of the left leg and ulcerated lesions evolving for two weeks prior. His medical history included epilepsy since childhood, mental retardation, chronic venous insufficiency, and chronic lymphedema complicated by recurrent ulceration and cellulitis. Over the previous four years, he had developed verrucous and papillomatous lesions on the left leg. A physical examination revealed an edematous leg with multiple painless coalescent verrucous skin-colored papules with a smooth or hyperkeratotic surface on the left lower leg surrounding the ulceration. The lesions were associated with oozing. A skin biopsy revealed hyperkeratosis, verrucoid acanthosis, and papillomatosis of the epidermis with moderate perivascular inflammatory infiltration of the dermis. A diagnosis of papillomatosis cutis lymphostatica (PCL) was reached based on histopathological and clinical findings. Our patient received lymphatic drainage and locally 5% salicylic acid.

Highlights

Papillomatosis cutis lymphostatica (PCL), or elephantiasis nostras verrucosa, is a rare, benign, and asymptomatic condition affecting usually the lower legs and resulting from chronic lymphedema [1]
An obese 53-year-old male presented himself to our department with lymphedema of the left leg and ulcerated lesions evolving for two weeks prior
His medical history included epilepsy since childhood, mental retardation, chronic venous insufficiency, and chronic lymphedema complicated by recurrent ulceration and cellulitis

Summary

INTRODUCTION

Papillomatosis cutis lymphostatica (PCL), or elephantiasis nostras verrucosa, is a rare, benign, and asymptomatic condition affecting usually the lower legs and resulting from chronic lymphedema [1]. An obese 53-year-old male presented himself to our department with lymphedema of the left leg and ulcerated lesions evolving for two weeks prior. His medical history included epilepsy since childhood, mental retardation, chronic venous insufficiency, and chronic lymphedema complicated by recurrent ulceration and cellulitis. A physical examination revealed an edematous leg with multiple painless coalescent verrucous skin-colored papules with a smooth or hyperkeratotic surface on the left lower leg surrounding an ulceration 10 × 5 cm in size (Fig. 1). The patient received lymphatic drainage and locally 5% salicylic acid

DISCUSSION

CONCLUSION