Resolution of septic shock in a patient with myelomeningocele (spina bifida) complicated with deforming Elephantiasis Nostras Verrucosa

.Elephantiasis nostras verrucosa (ENV) is an uncommon dermatologic complication of chronic nonfilarial lymphatic obstruction, characterized by dermal fibrosis and hyperkeratotic, verrucous and papillomatous lesions. Lymphedema predisposing ENV is present in 9% of cases of spina bifida. We present the case of a 36-year-old white man with a history of spina bifida with paralysis and bone deformity of the legs, obesity and chronic kidney disease (stage 3 - K/DOQI) due to chronic pyelonephritis referred to our hospital because of dyspnea.