Localized lymphedema (elephantiasis): A case series and review of the literature

Journal of Cutaneous Pathology

Volumn 36, Issue 1, 2009, Pages 1-20

  Lu, Song ^a   Tran, Tien Anh ^b   Jones, David M ^a   Meyer, Dale R ^a   Ross, Jeffrey S ^a   Fisher, Hugh A ^c   Carlson, John Andrew ^a  

^a ALBANY MEDICAL COLLEGE   (United States)

^b Florida Orlando Hospital   (United States)

^c Urological Institute of Northeastern New York   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

MINOCYCLINE; PEROXIDASE;

ADOLESCENT; ADULT; AGED; ARTICLE; BREAST DISEASE; CANCER SURGERY; CASE STUDY; CELL INFILTRATION; CELLULITIS; CLINICAL ASSESSMENT; CLINICAL FEATURE; CROHN DISEASE; ELEPHANTIASIS; EPIDERMIS HYPERPLASIA; EYELID DISEASE; FEMALE; FIBROSIS; FOLLICLE CYST; HISTOLOGY; HISTOPATHOLOGY; HUMAN; HYPERKERATOSIS; INFLAMMATORY INFILTRATE; LEG DISEASE; LYMPH FLOW; LYMPH FOLLICLE; LYMPH VESSEL; LYMPHATIC SYSTEM DISEASE; MAJOR CLINICAL STUDY; MALE; MORBID OBESITY; OBESITY; PLASMA CELL; POLYP; RETROSPECTIVE STUDY; ROSACEA; SARCOMA; SKIN BIOPSY; SKIN EDEMA; SKIN INJURY; SKIN TUMOR; STROMA CELL; TUMOR LOCALIZATION; TUMOR RECURRENCE; TUMOR VOLUME; VULVA DISEASE;

ADOLESCENT; ADULT; AGED; CASE-CONTROL STUDIES; ELEPHANTIASIS; FEMALE; HUMANS; MALE; MIDDLE AGED; OBESITY; SKIN DISEASES;

EID: 58149240135     PISSN: 03036987     EISSN: 16000560     Source Type: Journal    
DOI: 10.1111/j.1600-0560.2008.00990.x     Document Type: Article

References (145)

1. Ryan TJ. Structure and function of lymphatics. The Journal of investigative dermatology. 1989 93 (Suppl 18S.
2. Alitalo K, Tammela T, Petrova TV. Lymphangiogenesis in development and human disease. Nature 2005 438 : 946.
3. Angeli V, Randolph GJ. Inflammation, lymphatic function, and dendritic cell migration. Lymphat Res Biol 2006 4 : 217.
4. Harwood CA, Mortimer PS. Causes and clinical manifestations of lymphatic failure. Clin Dermatol 1995 13 : 459.
5. Rockson SG. Lymphedema. Am J Med 2001 110 : 288.
6. Warren AG, Brorson H, Borud LJ, Slavin SA. Lymphedema: a comprehensive review. Ann Plast Surg 2007 59 : 464.
7. Ryan TJ, De Berker D. The interstitium, the connective tissue environment of the lymphatic, and angiogenesis in human skin. Clin Dermatol 1995 13 : 451.
8. Ackerman AB, Böer A, Bennin B, Gottlieb GJ. Lymphedema. Histologic diagnosis of inflammatory skin diseases: an algorithmic method based on pattern analysis. New York City : Ardor Scribendi 2005. http://www.derm101.com/dynaweb/ resources/inflam/82632
9. Ostor AG, Fortune DW, Riley CB. Fibroepithelial polyps with atypical stromal cells (pseudosarcoma botryoides) of vulva and vagina. A report of 13 cases. Int J Gynecol Pathol 1988 7 : 351.
10. Mucitelli DR, Charles EZ, Kraus FT. Vulvovaginal polyps. Histologic appearance, ultrastructure, immunocytochemical characteristics, and clinicopathologic correlations. Int J Gynecol Pathol 1990 9 : 20.
11. Khalil AM, Nahhas DE, Shabb NS, et al. Vulvar fibroepithelial polyp with myxoid stroma: an unusual presentation. Gynecol Oncol 1994 53 : 125.
12. Gupta SC, Misra V, Gupta AK. Cavernous lymphangioma in the vulva. Tropical doctor. 1998 28 : 52.
13. Groisman GM, Polak-Charcon S. Fibroepithelial polyps of the anus: a histologic, immunohistochemical, and ultrastructural study, including comparison with the normal anal subepithelial layer. Am J Surg Pathol 1998 22 : 70.
14. Nucci MR, Fletcher CD. Vulvovaginal soft tissue tumours: update and review. Histopathology 2000 36 : 97.
15. Papiez JS, Hassenein A, Wilkinson E, Meynen CA. Recurrent atypical myxoid fibroepithelial polyp associated with vulvar Crohn's disease. Int J Gynecol Pathol 2001 20 : 271.
16. Fetsch JF, Davis CJ Jr., Hallman JR, Chung LS, Lupton GP, Sesterhenn IA. Lymphedematous fibroepithelial polyps of the glans penis and prepuce: a clinicopathologic study of 7 cases demonstrating a strong association with chronic condom catheter use. Hum Pathol 2004 35 : 190.
17. Turgut M, Yenilmez A, Can C, Bildirici K, Erkul A, Ozyurek Y. Fibroepithelial polyp of glans penis. Urology 2005 65 : 593.
18. Schutte AG, Tolentino M. A study of anal papillae. Diseases of the colon and rectum. 1962 5 : 2173.
19. Schutte AG, Tolentino MG. A second study of anal papillae. Dis Colon Rectum 1971 14 : 435.
20. Schinella RA. Stromal atypia in anal papillae. Dis Colon Rectum 1976 19 : 611.
21. Bang RL. Penile oedema induced by continuous condom catheter use and mimicking keloid scar. Scand J Urol Nephrol 1994 28 : 333.
22. Tope WD, Sangueza OP. Rhinophyma's fibrous variant. Histopathology and immunohistochemistry. Am J Dermatopathol 1994 16 : 307.
23. Juncker C, Honig M, Hormann K Gigantic tumor of the nose. Rhinophyma]. HNO 1997 45 : 636.
24. Chatelain R, Bell SA, Konz B, Rocken M Granuloma eosinophilicum faciei simulating rhinophyma. Therapeutic long-term outcome after surgical intervention]. Hautarzt 1998 49 : 496.
25. Racic G, Gluncic I, Tomic S, Petric S. Giant rhinophyma - a case report. Rhinology 1999 37 : 43.
26. Aloi F, Tomasini C, Soro E, Pippione M. The clinicopathologic spectrum of rhinophyma. J Am Acad Dermatol 2000 42 : 468.
27. Sharma R, Ramana YV, Makkar S, Nanda V. Giant rhinophyma: managing a social recluse. Plast Reconstr Surg 2005 115 : 2146.
28. Nucci MR, Young RH, Fletcher CD. Cellular pseudosarcomatous fibroepithelial stromal polyps of the lower female genital tract: an underrecognized lesion often misdiagnosed as sarcoma. Am J Surg Pathol 2000 24 : 231.
29. Orosz Z, Lehoczky O, Szoke J, Pulay T. Recurrent giant fibroepithelial stromal polyp of the vulva associated with congenital lymphedema. Gynecol Oncol 2005 98 : 168.
30. Carney JW. Solid edema of face. Arch Dermatol 1966 94 : 664.
31. Van Duyn J. Lymphedema in face scars. South Med J 1969 62 : 1149.
32. Van Duyn J. First appearance of lymphedema in facial scars. South Med J 1974 67 : 1502.
33. Helander I, Aho HJ. Solid facial edema as a complication of acne vulgaris: treatment with isotretinoin and clofazimine. Acta Derm Venereol 1987 67 : 535.
34. Friedman SJ, Fox BJ, Albert HL. Solid facial edema as a complication of acne vulgaris: treatment with isotretinoin. J Am Acad Dermatol 1986 15 (Pt 1 286.
35. Connelly MG, Winkelmann RK. Solid facial edema as a complication of acne vulgaris. Arch Dermatol 1985 121 : 87.
36. Tosti A, Guerra L, Bettoli V, Bonelli U. Solid facial edema as a complication of acne vulgaris in twins. J Am Acad Dermatol 1987 17 (Pt 1 843.
37. Humbert P, Delaporte E, Drobacheff C, et al. Solid facial edema associated with acne. Therapeutic efficacy of isotretinoin. Ann Dermatol Venereol 1990 117 : 527.
38. Camacho-Martinez F, Winkelmann RK. Solid facial edema as a manifestation of acne. J Am Acad Dermatol 1990 22 : 129.
39. Jungfer B, Jansen T, Przybilla B, Plewig G. Solid persistent facial edema of acne: successful treatment with isotretinoin and ketotifen. Dermatology 1993 187 : 34.
40. Mainetti C, Masouye I, Harms M, Saurat JH Solid persistent facial edema of the young adult. Melkersson-Rosenthal syndrome]. Ann Dermatol Venereol 1994 121 : 165.
41. Holzle E, Jansen T, Plewig G. [Morbihan disease - chronic persistent erythema and edema of the face]. Hautarzt 1995 46 : 796.
42. Mendez-Fernandez MA. Surgical treatment of solid facial edema: when everything else fails. Ann Plast Surg 1997 39 : 620.
43. Mazzatenta C, Giorgino G, Rubegni P, de Aloe G, Fimiani M. Solid persistent facial oedema (Morbihan's disease) following rosacea, successfully treated with isotretinoin and ketotifen. Br J Dermatol 1997 137 : 1020.
44. Mahajan PM. Solid facial edema as a complication of acne vulgaris. Cutis 1998 61 : 215.
45. Jansen T, Plewig G. The treatment of rosaceous lymphoedema. Clin Exp Dermatol 1997 22 : 57.
46. Uhara H, Kawachi S, Saida T. Solid facial edema in a patient with rosacea. J Dermatol 2000 27 : 214.
47. Dragan LR, Baron JM, Stern S, Shaw JC. Solid facial edema preceding a diagnosis of retro-orbital B-cell lymphoma. J Am Acad Dermatol 2000 42 (Pt 2 872.
48. Murphy MJ, Kogan B, Carlson JA. Granulomatous lymphangitis of the scrotum and penis. Report of a case and review of the literature of genital swelling with sarcoidal granulomatous inflammation. J Cutan Pathol 2001 28 : 419.
49. Kilinc I, Gencoglan G, Inanir I, Dereli T. Solid facial edema of acne: failure of treatment with isotretinoin. Eur J Dermatol 2003 13 : 503.
50. Baughman SM, Cespedes RD. Unusual presentation of hidradenitis suppurativa with massive enlargement of penis. Urology 2004 64 : 377.
51. Strauss RM, Clarke A, Lyon CC. An oedematous lesion in the nasolabial fold. Diagnosis: phymatous lesion with underlying rosacea. Clin Exp Dermatol 2006 31 : 729.
52. Buckland GT 3rd., Carlson JA, Meyer DR. Persistent periorbital and facial lymphedema associated with Group A beta-hemolytic streptococcal infection (erysipelas). Ophthal Plast Reconstr Surg 2007 23 : 161.
53. Warren AG, Slavin SA. Scar lymphedema: fact or fiction? Ann Plast Surg 2007 59 : 41.
54. Fiala KH, Wells MJ, Mullinax KA, Stetson CL, Paulger BR. Linear morphea presenting as acquired unilateral edema. Pediatr Dermatol 2007 24 : 147.
55. Laugier P, Gilardi S Chronic erythematous oedema of the upper face (Degos). Morbihan disease (author's transl)]. Ann Dermatol Venereol 1981 108 : 507.
56. Jansen T, Regele D, Schirren CG, Trautner B, Plewig G. [Persistent erythema and edema of the face associated with rosacea and lymph vessel dysplasia]. Hautarzt 1998 49 : 932.
57. Gubisch W. [Otophyma - a rare disease]. HNO 1983 31 : 56.
58. Hook B, Adam W. Otophyma and blepharophyma - two rare forms of sebaceous gland hyperplasia]. Z Hautkr 1980 55 : 1009.
59. Frugoni C. [Case of macrotia due to elephantiasis of the external ear.]. G Med Mil 1958 108 : 553.
60. Ayres S Jr., Jensen AK. Otorhinophyma pruritus and alopecia totalis syndrome. Arch Dermatol Syphilol 1947 56 : 379.
61. Senear FE, Weichselbaum PK. Rosacea and rhinophyma (nose and ears). Arch Dermatol Syphilol 1945 52 : 201.
62. Hörbst L, Loos HO. Über Elephantiasis der Ohrmuschel. Arch Dermatol Syphilol 1932 166 : 342.
63. Mahzoon S, Azadeh B. Elephantiasis of external ears: a rare manifestation of pediculosis capitis. Acta Derm Venereol 1983 63 : 363.
64. Ekmekci TR, Koslu A, Sakiz D. A case of otophyma. Clin Exp Dermatol 2005 30 : 441.
65. Carlson JA, Mazza J, Kircher K, Tran T. Otophyma: a case report and review of the literature of lymphedema (elephantiasis) of the ear. Am J Dermatopathol 2007 30 (1 67.
66. Hadway P, Lynch M, Corbishley CM, Mortimer PS, Watkin NA. Squamous cell carcinoma of the penis in a patient with chronic isolated penile lymphoedema. Urol Int 2006 76 : 87.
67. Malak J, Hadi U. Otic rosacea. Arch Otolaryngol Head Neck Surg 1999 125 : 479.
68. Tokuda Y, Kawachi S, Murata H, Saida T. Chronic obesity lymphoedematous mucinosis: three cases of pretibial mucinosis in obese patients with pitting oedema. Br J Dermatol 2006 154 : 157.
69. Schultz-Ehrenburg U, Niederauer HH, Tiedjen KU. Stasis papillomatosis. Clinical features, etiopathogenesis and radiological findings. J Dermatol Surg Oncol 1993 19 : 440.
70. Wrone DA, Landeck A, Dibbell DG, Xie H, Warner TF. Hidradenitis suppurativa polyposa. Pathol Res Pract 2000 196 : 589 discussion 93.
71. Roy KK, Agarwal R, Agarwal S, Kumar S, Malhotra N, Gopendru N. Recurrent vulval congenital lymphangioma circumscriptum - a case report and literature review. Int J Gynecol Cancer 2006 16 : 930.
72. Maheshwari M, Khandelwal S, Maheshwari S. Elephantiasis nostras: complication of third degree acid burn. J Assoc Physicians India 2006 54 : 713.
73. Allen RK, Leveck TW. Elephantiasis nostras verrucosa. J Dermatol Surg Oncol 1980 6 : 65.
74. Baughman SA, Beninson J. Elephantiasis nostras - a case report. Angiology 1988 39 : 164.
75. Stoberl C, Partsch H. Papillomatous cutis in chronically swollen legs - a sign of local damage of dermal lymph-drainage. Progr Lymphol. 1988 XI : 217.
76. Sato T, Katagiri K, Itami S, Takayasu S. A case of stasis papillomatosis associated with psoriasis vulgaris. J Dermatol 1996 23 : 352.
77. Faye O, Petit F, Poli F, et al. [Lymphoedema as a complication of hidradenitis suppurativa in three patients]. Ann Dermatol Venereol 2007 134 : 567.
78. Franco G, Toma L, Nosotti L, Muscardin LM, Morrone A. Vulvar lymphangiectases on female genital mutilation mimicking genital warts. J Eur Acad Dermatol Venereol 2006 20 : 1017.
79. Grant JM. Elephantiasis nostras verrucosa of the ears. Cutis 1982 29 : 441.
80. Daniels K, Haddow K. Otophyma: a case report. J Laryngol Otol 2007 22 : 1.
81. O'Donnell BF, Foulds IS. Visual impairment secondary to rosacea. Br J Dermatol 1992 127 : 300.
82. Scerri L, Saihan EM. Persistent facial swelling in a patient with rosacea. Rosacea lymphedema. Arch Dermatol 1995 131 : 1071.
83. Chen DM, Crosby DL. Periorbital edema as an initial presentation of rosacea. J Am Acad Dermatol 1997 37 (Pt 2 346.
84. Bernardini FP, Kersten RC, Khouri LM, Moin M, Kulwin DR, Mutasim DF. Chronic eyelid lymphedema and acne rosacea. Report of two cases. Ophthalmology 2000 107 : 2220.
85. Kabir SM, Raurell A, Ramakrishnan V. Lymphoedema of the eyelids. Br J Plast Surg 2002 55 : 153.
86. Bechara FG, Jansen T, Losch R, Altmeyer P, Hoffmann K. Morbihan's disease: treatment with CO2 laser blepharoplasty. J Dermatol 2004 31 : 113.
87. Marzano AV, Vezzoli P, Alessi E. Elephantoid oedema of the eyelids. J Eur Acad Dermatol Venereol 2004 18 : 459.
88. Lai TF, Leibovitch I, James C, Huilgol SC, Selva D. Rosacea lymphoedema of the eyelid. Acta Ophthalmol Scand 2004 82 : 765.
89. Harvey DT, Fenske NA, Glass LF. Rosaceous lymphedema: a rare variant of a common disorder. Cutis 1998 61 : 321.
90. van de Scheur MR, van der Waal RI, van der Waal I, Stoof TJ, van Deventer SJ. Ano-genital granulomatosis: the counterpart of oro-facial granulomatosis. J Eur Acad Dermatol Venereol 2003 17 : 184.
91. Chernosky ME, Derbes VJ. Elephantiasis nostras of the abdominal wall. Arch Dermatol 1966 94 : 757.
92. Rudolph RI, Gross PR. Elephantiasis nostras verrucosa of the panniculus. Arch Dermatol 1973 108 : 832.
93. Farshid G, Weiss SW. Massive localized lymphedema in the morbidly obese: a histologically distinct reactive lesion simulating liposarcoma. Am J Surg Pathol 1998 22 : 1277.
94. Wu D, Gibbs J, Corral D, Intengan M, Brooks JJ. Massive localized lymphedema: additional locations and association with hypothyroidism. Hum Pathol 2000 31 : 1162.
95. Vang R, Connelly JH, Hammill HA, Shannon RL. Vulvar hypertrophy with lymphedema. A mimicker of aggressive angiomyxoma. Arch Pathol Lab Med 2000 124 : 1697.
96. Barr J. Massive localized lymphedema of suprapubic origin. Plast Reconstr Surg 2000 106 : 1663.
97. Vana J, Adamicova K, Haluska P, Celec J. [Massive localized lymphedema in an extremely obese patient]. Chirurg 2002 73 : 383.
98. Hanna D, Cloutier R, Lapointe R, Desgagne A. Abdominal elephantiasis: a case report. J Cutan Med Surg 2004 8 : 229.
99. Goshtasby P, Dawson J, Agarwal N. Pseudosarcoma: massive localized lymphedema of the morbidly obese. Obes Surg 2006 16 : 88.
100. Richards RN. Verrucous and elephantoid lymphedema: morphologic spectrum and terminology. Int J Dermatol 1981 20 : 177.
101. Goldberg JM, Buchler DA, Dibbell DG. Advanced hidradenitis suppurativa presenting with bilateral vulvar masses. Gynecol Oncol 1996 60 : 494.
102. Konety BR, Cooper T, Flood HD, Futrell JW. Scrotal elephantiasis associated with hidradenitis suppurativa. Plast Reconstr Surg 1996 97 : 1243.
103. Brooks JS, Cihak RW. Not so massive localized lymphedema. Hum Pathol 2001 32 : 139.
104. Kuepper D. Giant scrotal elephantiasis. Urology 2005 65 : 389.
105. Modolin ML, Cintra W Jr., Paggiaro AO, Faintuch J, Gemperli R, Ferreira MC. Massive localized lymphedema (MLL) in bariatric candidates. Obes Surg 2006 16 : 1126.
106. Jensen V, Witte MH, Latifi R. Massive localized lipolymphedema pseudotumor in a morbidly obese patient. Lymphology 2006 39 : 181.
107. Salas Cabrera R, More Perez F. [Giant scrotal lymphedema]. Arch Esp Urol 2007 60 : 195.
108. Salinas Martin MV, Hernandez Gonzalo D, Munoz Repeto I, Gavilan Carrasco F. [Massive localized lymphedema mimicking a soft tissue neoplasm associated with previous surgery and morbid obesity.]. Cir Esp 2007 82 : 52.
109. Weston S, Clay CD. Unusual case of lymphoedema in a morbidly obese patient. Austral J Dermatol 2007 48 : 115.
110. McCrystal DJ, O'Loughlin BS. Massive localized lymphoedema of the thigh. ANZ J Surg 2007 77 : 91.
111. Oswald TM, Lineaweaver W. Limited segmental resection of symptomatic lower-extremity lymphodystrophic tissue in high-risk patients. South Med J 2003 96 : 689.
112. Adamicova K, Vana J, Celec J, Haluska P. [Massive localized lymphedema: a reactive lesion simulating liposarcoma (case report]. Cesk Patol 2002 38 : 125.
113. Swanson DL. Genital lymphangioma with recurrent cellulitis in men. Int J Dermatol 2006 45 : 800.
114. Denzinger S, Watzlawek E, Burger M, Wieland WF, Otto W. Giant scrotal elephantiasis of inflammatory etiology: a case report. J Med Case Reports 2007 1 : 23.
115. Garcia-Tutor E, Botelle del Hierro J, San Martin Maya A, et al. [Surgical treatment of penile lymphedema associated with hidradenitis suppurativa]. Actas Urol Esp 2005 29 : 519.
116. Carlson JA, LeBoit PE. Localized chronic fibrosing vasculitis of the skin: an inflammatory reaction that occurs in settings other than erythema elevatum diutinum and granuloma faciale. Am J Surg Pathol 1997 21 : 698.
117. Weigand DA. Microscopic features of lichen sclerosus et atrophicus in acrochordons: a clue to the cause of lichen sclerosus et atrophicus? J Am Acad Dermatol 1993 28 (Pt 1 751.
118. Kaiserling E. Morphologic changes in lymphedema and tumors. In Földi M, Földi E, eds. Földi's textbook of lymphology. Munich : Elsevier GmbH 2006 224.
119. Földi E, Földi M. Lymphostatic diseases. In Földi M, Földi E, eds. Földi's textbook of lymphology. Munich : Elsevier GmbH 2006 224.
120. Paskett ED, Naughton MJ, McCoy TP, Case LD, Abbott JM. The epidemiology of arm and hand swelling in premenopausal breast cancer survivors. Cancer Epidemiol Biomarkers Prev 2007 16 : 775.
121. Beesley V, Janda M, Eakin E, Obermair A, Battistutta D. Lymphedema after gynecological cancer treatment: prevalence, correlates, and supportive care needs. Cancer 2007 109 : 2607.
122. Ryan M, Stainton MC, Slaytor EK, Jaconelli C, Watts S, Mackenzie P. Aetiology and prevalence of lower limb lymphoedema following treatment for gynaecological cancer. Aust N Z J Obstet Gynaecol 2003 43 : 148.
123. Mortimer P, Bates DO, Brassington HD, Stanton AWB, Strachan DP, Levick JR. The prevalence of arm oedema following treatment for breast cancer. Q J Med 1996 89 : 377.
124. Wohlrab J, Lueftl M, Marsch WC. Persistent erythema and edema of the midthird and upper aspect of the face (morbus morbihan): evidence of hidden immunologic contact urticaria and impaired lymphatic drainage. J Am Acad Dermatol 2005 52 : 595.
125. Sibenge S, Gawkrodger DJ. Rosacea: a study of clinical patterns, blood flow, and the role of Demodex folliculorum. J Am Acad Dermatol 1992 26 : 590.
126. Gomaa AH, Yaar M, Eyada MM, Bhawan J. Lymphangiogenesis and angiogenesis in non-phymatous rosacea. J Cutan Pathol 2007 34 : 748.
127. Rohrich RJ, Griffin JR, Adams WP Jr. Rhinophyma: review and update. Plast Reconstr Surg 2002 110 : 860 quiz 70.
128. Baskin ML, Ard J, Franklin F, Allison DB. Prevalence of obesity in the United States. Obes Rev 2005 6 : 5.
129. The diagnosis and treatment of peripheral lymphedema. Consensus document of the International Society of Lymphology. Lymphology 2003 36 : 84.
130. Olszewski WL, Engeset A, Romaniuk A, Grzelak I, Ziolkowska A. Immune cells in peripheral lymph and skin of patients with obstructive lymphedema. Lymphology 1990 23 : 23.
131. Olszewski WL, Jamal S, Manokaran G, Lukomska B, Kubicka U. Skin changes in filarial and non-filarial lymphoedema of the lower extremities. Trop Med Parasitol 1993 44 : 40.
132. Tabibiazar R, Cheung L, Han J, et al. Inflammatory manifestations of experimental lymphatic insufficiency. PLoS Med 2006 3 : e254.
133. Ruocco E, Puca RV, Brunetti G, Schwartz RA, Ruocco V. Lymphedematous areas: privileged sites for tumors, infections, and immune disorders. Int J Dermatol 2007 46 : 662.
134. Pani SP, Yuvaraj J, Vanamail P, et al. Episodic adenolymphangitis and lymphoedema in patients with bancroftian filariasis. Trans R Soc Trop Med Hyg 1995 89 : 72.
135. Dissanayake S. In Wuchereria bancrofti filariasis, asymptomatic microfilaraemia does not progress to amicrofilaraemic lymphatic disease. IntJ Epidemiol 2001 30 : 394.
136. Olszewski WL, Jamal S, Manokaran G, et al. Bacteriological studies of blood, tissue fluid, lymph and lymph nodes in patients with acute dermatolymphangioadenitis (DLA) in course of 'filarial' lymphedema. Acta Trop 1999 73 : 217.
137. Olszewski WL, Jamal S, Manokaran G, et al. Bacteriologic studies of skin, tissue fluid, lymph, and lymph nodes in patients with filarial lymphedema. Am J Trop Med Hyg 1997 57 : 7.
138. Debrah AY, Mand S, Specht S, et al. Doxycycline reduces plasma VEGF-C/sVEGFR-3 and improves pathology in lymphatic filariasis. PLoS Pathog 2006 2 : e92.
139. Garcia Hidalgo L. Dermatological complications of obesity. Am J Clin Dermatol 2002 3 : 497.
140. Strössenreuther RHK, Brenke R, Forster R, Freund R, Klose G, Sonderegger A. Decongestive kinesiotherapy, respiratory therapy, physiotherapy and other physical therapy techniques. In Földi M, Földi E, eds. Földi's textbook of lymphology. Munich : Elsevier GmbH 2006 : 224.
141. Culbertson WW, Ostler HB. The floppy eyelid syndrome. Am J Ophthalmol 1981 92 : 568.
142. Netland PA, Sugrue SP, Albert DM, Shore JW. Histopathologic features of the floppy eyelid syndrome. Involvement of tarsal elastin. Ophthalmology 1994 101 : 174.
143. Schlotzer-Schrehardt U, Stojkovic M, Hofmann-Rummelt C, Cursiefen C, Kruse FE, Holbach LM. The pathogenesis of floppy eyelid syndrome: involvement of matrix metalloproteinases in elastic fiber degradation. Ophthalmology 2005 112 : 694.
144. Brorson H, Ohlin K, Olsson G, Nilsson M. Adipose tissue dominates chronic arm lymphedema following breast cancer: an analysis using volume rendered CT images. Lymphat Res Biol 2006 4 : 199.
145. Acker DW, Helwig EB. Rhinophyma with carcinoma. Arch Dermatol 1967 95 : 250.