Microscopic examination of the biopsy specimen revealed hyperkeratosis without keratinocytic dysplasia and dilated lymphatic vessels with increased dermal fibrosis. These findings in conjunction with the clinical history led to the diagnosis of self-induced ENV.
Elephantiasis nostras verrucosa, which is one of the most poorly understood dermatologic disorders, has also been called elephantiasis nostras, elephantiasis verrucosa, elephantiasis crurum papillaris et verrucosa, lymphostatic papillomatosis cutis, lymphostatic verrucosa, papillomatosis cutis verrucosa, and pachydermia vegetans.1 It is characterized by enlargement of a body part, with marked edema, dermal fibrosis, and epidermal changes resulting in a hyperkeratotic, verrucous, and papillated surface, and occurs most commonly after a surgical intervention, radiation, infection, or tumor leads to lymphatic obstruction.1 There is a female predilection, and the upper and lower extremities are the most common sites.2 However, different sites of involvement, such as the buttocks,3 penis,4 lips,5,6 ears,7 and abdominal wall,8 have also been reported.
Verrucous Penile Lesions on a Man With Paraplegia. Arch Dermatol. 2001;137(8):1095-1100. doi: