[Illustration: FIG. 97.--Elephantiasis in a woman aet. 45.]
A similar type of elephantiasis may occur after extirpation of the lymph
glands in the axilla or groin; in the leg in long-standing standing
varix and phlebitis with chronic ulcer; in the arm as a result of
extensive cancerous disease of the lymphatics in the axilla secondarily
to cancer of the breast; and in extensive tuberculous disease of the
lymphatics. The last-named is chiefly observed in the lower limb in
young adult women, and from its following upon lupus of the toes or foot
it has been called _lupus elephantiasis_. The tuberculous infection
spreads slowly up the limb by way of the lymph vessels, and as these are
obliterated the skin and cellular tissues become hypertrophied, and the
surface is studded over with fungating tuberculous masses of a livid
blue colour. As the more severe forms of the disease may prove dangerous
to life by pyogenic complications inducing gangrene of the limb, the
question of amputation may have to be considered.
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