Nodular fibrosis: a rare complication of non filarial lymph edema.

Lymphedema is a soft-tissue swelling that occurs following lymphatic fluid accumulation. Edema is due to insufficient lymphatic drainage that occurs because of lymphatic vessel obstruction or absence [1]. Chronic lymphedema can cause a clinical picture of tense non-pitting edema with thickened epidermis that is due to accumulation of protein and lipids in the connective tissue. In the early stages pitting edema is seen, but with progression of disease, fibrosis occurs and then edema becomes tense. Hyperplasic changes with warty epidermis and then elephantiasis become evident. The disability due to limb swelling can be severe but the overall prognosis is good [1]. Nodular fibrosis is an uncommon complication of elephantiasis [2].