Nwabudike Lawrence Chukwudi, Buzia Olimpia, Elisei Alina Mihaela, Tatu Alin Laurentiu
Outpatient Dermatology Department, 'Dr. N.C. Paulescu' National Institute of Metabolic Disease, Nutrition and Diabetes, 020475 Bucharest, Romania.
Multidisciplinary Integrated Center of Dermatological Interface Research (MIC-DIR), 800010 Galati, Romania.
Exp Ther Med. 2022 Apr;23(4):289. doi: 10.3892/etm.2022.11218. Epub 2022 Feb 16.
Elephantiasis nostras is a chronic disorder that is difficult to treat. It is characterized by marked lymphedema, associated with hyperkeratosis, ulceration, deep skin folds and a cobblestone appearance of the skin. Causes include parasitic and bacterial infections, neoplasia and obesity, but numerous cases have uncertain aetiology. Treatment includes surgery and medication, which are associated with variable results. In the present study, a 72-year old female with renal insufficiency presented with leg enlargement of 3-4 years duration, which rendered her housebound. Examination showed massive lower limb enlargement, with typical cobblestone appearance. She was on furoseminde 80 mg/day. A diagnosis of elephantiasis nostras was made. Then, she was treated with increased furosemide from 80 to 120 mg daily and homeopathic , CH30 potency, Unavailability of corresponding fit excluded the use of compressive stockings. The patient remitted over 18 months, with limb diameters dropping from 68/46 cm (right mid-calf/ankle) and 67/43 cm (left mid-calf/ankle) to 64/43 cm (right mid-calf/ankle) and 64.5/45 cm (left mid-calf/ankle) at 6 months, 63/42 cm (right mid-calf/ankle) and 65/41 cm (left mid-calf/ankle) at 12 months, and 46/35 cm (right mid-calf/ankle) and 48/36 cm (left mid-calf/ankle) at 18 months, with improvement of skin appearance. Elephantiasis nostras is not spontaneously remitting. In this resource-limited setting, furosemide combined with homeopathic has proved valuable and may be used for similar cases.
nostras象皮病是一种难以治疗的慢性疾病。其特征为明显的淋巴水肿，并伴有角化过度、溃疡、皮肤深褶皱以及皮肤呈鹅卵石样外观。病因包括寄生虫和细菌感染、肿瘤形成及肥胖，但许多病例的病因不明。治疗方法包括手术和药物治疗，疗效不一。在本研究中，一名72岁肾功能不全的女性出现腿部肿大3至4年，导致她只能居家不出。检查显示下肢明显肿大，呈典型的鹅卵石样外观。她每天服用80毫克速尿。诊断为nostras象皮病。随后，她的速尿剂量从每天80毫克增加到120毫克，并接受顺势疗法，CH30药力。由于无法找到合适的产品，未使用加压弹力袜。患者在18个月内病情缓解，肢体直径在6个月时从68/46厘米（右小腿中部/脚踝）和67/43厘米（左小腿中部/脚踝）降至64/43厘米（右小腿中部/脚踝）和64.5/45厘米（左小腿中部/脚踝），12个月时为63/42厘米（右小腿中部/脚踝）和65/41厘米（左小腿中部/脚踝），18个月时为46/35厘米（右小腿中部/脚踝）和48/36厘米（左小腿中部/脚踝），皮肤外观也有所改善。nostras象皮病不会自发缓解。在这种资源有限的情况下，速尿联合顺势疗法已被证明是有价值的，可用于类似病例。
