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case_images: Clinical image of skin lesions before treatment. (A) Skin lesions on lower legs. (B) Erythematous plaques on left thigh. (C) Verrucous plaques on left lower leg.
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case_images: A 52-year-old-woman presented to our hospital with bilateral leg swelling (Figure 1A), itchy erythematous (Figure 1B) and verrucous plaques (Figure 1C) on her lower legs that had persisted for 2 years.
case_images: Histopathology and imaging. (A) Doppler ultrasonography. Multiple hypoechoic lesions on left leg showing avascularization indicate lymphedema (yellow box). (B) Histopathological results. Hyperkeratosis of the epidermis (green arrow), loss of sweat glands (yellow arrow), and dilated lymph vessels (red arrows) supported diagnosis of ENV.
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case_images: Doppler sonography (Figure 2A) and lymphoscintigraphy of the lower legs revealed lymphedema and lymphatic stasis. Histopathological examination revealed extensive fibrous tissue hyperplasia in the dermis, loss of sweat glands, and dilated lymph channels (Figure 2B).
case_images: Clinical image of skin lesions 2 months after treatment. (A) Skin lesions on lower legs. (B) Erythematous plaques on left thigh. (C) Verrucous plaques on left lower leg.
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case_images: After 2 months, partial resolution of skin lesions on her lower legs (Figure 3A), especially the erythematous plaques on her left thigh (Figure 3B), and verrucous plaques on left lower leg (Figure 3C) were observed.