The last, 5th stage of clinical lymphedema of the lower extremities. The limb totally loses its normal anatomic shape and, mostly because of massive edema of the ankle and leg, acquires a cylindrical shape, which looks like an elephant leg. Coupled with this morphostructural dysfunction, also skin anomalies are often present involving sclerotic processes – also called sclerodermic pachidermitis – which make the legs of patients with this condition even more similar to those of elephants.