Chronically oedematous (see OEDEMA) and thickened tissue, especially involving the lower extremities and genitalia, which arises from repeated attacks of inflammation of the skin and subcutaneous tissue, with concurrent obstruction of lymphatic vessels. In a tropical country, the usual cause is lymphatic FILARIASIS. Wuchereria bancrofti or Brugia malayi are conveyed to humans by a mosquito bite. Resultant lymphatic obstruction gives rise to enlargement and disfiguration, with thickening of the skin (resembling that of an elephant) in one or both lower limbs and occasionally genitalia (involving particularly the SCROTUM). By the time the condition is recognised, lymphatic damage is irreversible. However, if evidence of continuing activity exists, a course of diethylcarbamazine may be advised (see FILARIASIS). Relief can be obtained by using elastic bandaging, massage, rest, and elevation of the affected limb. Surgery is sometimes recommended.