Cutaneous metastatic carcinoma and elephantiasis symptomatica

An elderly man had elephantiasis of a lower extremity that was partially covered with verrucose papules, but also had sharply delineated islands of normal-appearing skin. Biopsy showed cutaneous metastases to be responsible, at least in part, for the clinical appearance. Patients with elephantiasis with "skipped areas" should be suspected of having cutaneous metastatic malignant neoplasms.