An obese, constitutionally inferior woman had a massive apron-like abdominal wall studded with firm papular lesions on its inferior aspect. Biopsy showed acanthosis, greatly thickened dermis, and many dilated lymph vessels. A low calorie diet and much encouragement caused her to lose 53.5 kg (118 lb). Simultaneously most of the papular lesions disappeared. The excess abdominal wall was excised. One year later she was readmitted weighing over 181.6 kg (400 lb). Her death was ascribed to pulmonary edema, acute pyelonephritis, and obesity.
CHERNOSKY ME, DERBES VJ. Elephantiasis Nostras of the Abdominal Wall. Arch Dermatol. 1966;94(6):757–762. doi:10.1001/archderm.1966.01600300081017
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