Taming elephantiasis with acitretin

We present two patients with elephantiasis nostras verrucosa of the lower limbs which improved with oral acitretin. One patient was young and otherwise well while the other was a diabetic with multiple co-morbidities. The treatment was well tolerated and resulted in flattening of verrucous and hyperkeratotic skin lesions and a reduction in frequency and severity of cellulitic events. There was also an improvement in cosmetic appearance and mobility. Treatment with oral acitretin may improve the quality of life of patients with this chronic dermatosis and should be considered in carefully selected patients.