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| Fig. 33.4 Marked scrotal enlargement in elephantiasis. (From Zaiman H, Jong EC: Parasitic diseases of the skin and soft tissue. In Stevens DL, editor: Atlas of infectious diseases, vol II, New York, 1995, Churchill Livingstone.) |
The term
elephantiasis is applied to many dermatologic conditions that ultimately result in severe lymphatic obstruction and stasis. The affected limb may become massively enlarged, initially with pitting edema but later with a woodlike induration. The skin becomes discolored, and patches of warty growths may eventually cover the entire affected area. Lymphangitis and mechanical obstruction from lymphatic filariasis is but one way of causing elephantiasis. Offending organisms include
Wuchereria bancrofti, Brugia malayi, and B. timori. The Brugia species cause elephantiasis of the extremities most commonly, while
Wuchereria is notorious for genital disease that may eventuate in massive scrotal enlargement (Fig. 33-4).
