elephant skin

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elephant skin

Dermatology
A descriptive term for skin with subcutaneous oedema, redundancy and dermal thickening (elephantiasis), which is seen in infection by Onchocerca volvulus.
 
ENT
A fanciful term for Grade-3 laryngeal oedema caused by prolonged acid reflux, with redundant thickened mucosa and an airway to laryngeal diameter ratio of less than one-half.
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At least two of the Alvinellid group species (Peltospira operculata and Pachydermia laevis) have been reported from vestimentiferan clumps (Govenar et al., 2005) or mussel collections (Van Dover, 2003) at nearby sites.
The three members of the family Neomphalidae that were included in our study (Cyathermia naticoides, Neomphalus fretterae, and Pachydermia laevis) were associated with warmer regions of the vestimentiferan zone or with alvinellids.
5 Pachydermia laevis 2 Warm Rhynchopelta concentrica +++ + 3 Cyathermia naticoides +++ +++ 2 Lepetodrilus cristatus 6 1 Lepetodrilus elevatus +++ +++ +++ +++ Lepetodrilus pustulosus ++ + +++ 2 Cool Clypeosectus delectus 4 Eulepetopsis vitrea 7 2 1 Gorgoleptis spiralis 1 3 Lepetodrilus ovalis 2 + 7 Other Bathymargarites symplector 1 9 2 2 Gorgoleptis emarginatus Phymorhynchus sp.
PDP has 3 forms: complete form has periostosis and pachydermia, an incomplete form has abnormalities in bone and decreased or absent pachydermia and 'forme fruste' has marked pachydermia and minimum or decreased bone changes.
On physical examination, pachydermia and furrowing of skin over forehead and chin, seborrhoea, cutis verticis gyrata of the scalp, bilateral clubbing of fingers and toes were seen (Figure 1).
The disease presents with three possible presentations: a complete form showing pachydermia, periostosis and acropachy; the incomplete form showing only periostosis and acropachy; and the forme fruste or minimal/mild form showing only pachydermia with minimal or absent bone modifications.
The three major criteria are pachydermia, periostosis, and digital clubbing.
Grade 3 represents diffuse pachydermia laryngis ("elephant skin" of the larynx), wherein the ratio of the airway to the overall laryngeal diameter is less than one-half.
Direct examination of the larynx also allows for the detection of increased supraglottic vascularity, laryngeal or subglottic edema, interarytenoid pachydermia, and small lymphoid aggregates in the wall of the trachea; all of these findings are suggestive of GERD.
His arytenoids were mildly erythematous and mildly to moderately edematous, and there was a mild degree of pachydermia laryngis in the interarytenoid region, suggestive of reflux laryngitis.
Six months after our initial examination, the inferior glottic ridges and the voice remained stable, and the pachydermia laryngis and posterior laryngeal edema and erythema had diminished significantly.