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April 1977

Dermatolipidectomy of Elephantiasis Nostras Verrucosa of the Panniculus

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Arch Dermatol. 1977;113(4):521. doi:10.1001/archderm.1977.01640040129028

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To the Editor.—  In 1973, Rudolph and Gross reported in the Archives of Dermatology (108:832, 1973) a case of elephantiasis nostra verrucosa of the panniculus. An etiology of obesity, repeated episodes of erysipelas, and chronic passive congestion was proposed.During the past three years, the patient had been receiving erythromycin and had been free of cutaneous infection. In spite of stable weight, the massive abdominal apron had become a physical and social problem (Fig 1).The patient recently was operated upon for relief of her physical complaints. An abdominal dermatolipectomy was done, with resection of 6.8 kg of fat, scarred subcutaneous tissue, and the plate of verrucoid skin (Fig 2). Significantly enlarged vascular channels were found supplying this dependent tissue mass. Primary wound healing was achieved, and the patient obtained marked relief.Fig 1.—Elephantiasis nostras verrucosa of panniculus. Note verrucoid pattern of abdominal skin.Fig 2.—Early postoperative view. There

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