A 32-year-old male patient presented with recurrent episodes of fever, redness, and painful edema of the right leg and pain over the right inguinal region of 20 years duration with edema persisting in between exacerbations. On examination, there was non-pitting pedal edema predominantly over the dorsum of the right foot. Dermatological examination revealed multiple discrete and pedunculated papules and plaques with verrucous surface over the dorsal [Figure 1] and the lateral [Figure 2] aspects of the right foot and 2nd to 4th toes. Kaposi-stemmer sign was positive.
Lymphostatic verrucosis, also known as elephantiasis nostras verrucosa, is a rare form of chronic lymphoedema that causes progressive cutaneous hypertrophy leading to severe disfigurement of body parts (especially of lower limbs) with gravity dependent blood flow.