Vulval elephantiasis: a case report

Area of Science:

• Medical Parasitology
• Dermatopathology
• Tropical Medicine

Background:

• Elephantiasis is a chronic manifestation of filariasis, typically affecting limbs, scrotum, and trunk.
• Females exhibit a lower incidence of filarial infection, making vulval elephantiasis exceedingly rare.
• Histopathological diagnosis is challenging due to the infrequent identification of the parasite in tissue sections.

Purpose of the Study:

• To report a rare case of vulval elephantiasis caused by filariasis in a young female.
• To highlight the diagnostic challenges and necessary investigations for this uncommon condition.
• To emphasize the importance of integrating clinical, histopathological, and laboratory findings for accurate diagnosis.

Main Methods:

• Clinical presentation of a young female with progressive vulval swelling over two years.
• Exclusion of differential diagnoses through comprehensive clinical evaluation.
• Ancillary diagnostic tests, including histopathology and potentially microfilariae detection or antigen testing, were employed.

Main Results:

• A case of vulval elephantiasis in a young female was diagnosed.
• The swelling measured 5 × 6 cm and was characterized as soft.
• Histopathological examination, combined with exclusion of other conditions, led to the diagnosis.

Conclusions:

• Vulval elephantiasis due to filariasis is a rare clinical entity.
• Diagnosis often relies on exclusion and a high index of suspicion, as direct parasite identification is infrequent.
• Accurate diagnosis necessitates correlating microscopic findings with relevant laboratory diagnostic tests.