Differential diagnosis The differential diagnosis for<unk>  includes other causes of tropical lymphedema, such as filariasis or leprosy, and mycetoma pedis. While filariasis is generally unilateral,<unk>  affects the legs bilaterally albeit asymmetrically and in an ascending manner.<unk>  very rarely affects the groin while filariasis frequently involves the groin: a high ratio of lymphoedema/hydrocele cases in an area suggests<unk>  as the dominant cause of lymphedema. In some cases, the history and clinical presentation alone are unable to differentiate between the two causes of tropical lymphedema. Local epidemiology can also be a clue to diagnosis, as<unk>  is typically found in higher altitude areas with volcanic soils while filariasis is common in low-lying areas where mosquitos are prevalent. Blood smears for identification of microfilariae and antigen detection techniques can be helpful in the diagnosis of lymphatic filariasis. Lepromatous lymphedema can also mimic<unk>  clinically, but the former will have loss of sensation in the toes and feet, thickened nerves, and trophic ulcers. Other causes of lymphedema include Kaposi sarcoma, mycetoma, and elephantiasis nostras verrucosa.
Podoconiosis
Silica granuloma
Beryllium granuloma
Pasteurellosis
Spongiosis
Pulmonary talcosis
Contact granuloma
Silicone granuloma