Nodular subepidermal fibrosis in non-filarial endemic elephantiasis of the legs

Nodular subepidermal fibrosis is a common complication of non‐filarial elephantiasis of the lower legs. It occurs in the ‘rubbery’ type of elephantiasis only. The sites of predilection correspond to areas exposed to microtraumata; the sole and the leg above the ankle are never involved by nodulation. The microscopic appearances are described. Treatment, which is demanded by the patient for aesthetic reasons, or required as a preparatory measure for footwear, is surgical removal of the nodules.