#1
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Case Report: We described a case of a 49-year-old obese Chinese man with no known medical illness who had been under close observation for the bilateral lower limbs swelling and disfigurement for 2 years. The lesions started 30 years ago, initially described as skin thickening, worsening into nodules and thick plaque formation, but he did not seek treatment. There was lost of sensation over the hyperkeratotic skin of bilateral lower limbs. A skin biopsy showed a benign fibroepithelial polyp with some reactive changes with no features of malignancy. The lower limbs disfigurements had restricted his daily activities and he became unemployed and remained single. Limited activities had in turn worsened his lymphoedema. |
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#2
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#3
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Some of the nodules were ulcerated with foul-smelling serous discharge. His functional status was severely impaired with a loss of ankle function, and required walking frames for ambulation. He was admitted to hospital for six times in the past 2 years for recurrent cellulitis and lower limb pain. He was treated with multiple courses of antibiotic, including cloxacillin, amoxicillin-clavulanate and cefuroxime but showed no improvement. He was advised for an amputation of bilateral lower limbs in view of recurrent infections with a loss of ankle function. He refused to have any surgical intervention. |
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