Podoconiosis is caused by repeatedly walking barefoot in volcanic soils, which contain tiny, sharp mineral crystals that can penetrate the soles of the feet. For some people, once these crystals are under the skin, they provoke repeated cycles of inflammation. Over time, the inflammation produces a build-up of scar tissue that eventually blocks lymphatic vessels and produces dramatic and disabling swelling and open sores in the lower legs.
According to the WHO, this type of elephantiasis is typically associated with farming and years of working barefoot in freshly turned soil.

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