Dermoscopic evaluation of a rare disseminated cutaneous miliarial gout: A case report

Gout is a disorder of purine metabolism, and it results from long-standing hyperuricemia and monosodium urate crystal deposition in various tissues. Miliarial gout is the least reported of chronic tophaceous gout. We present a case of a 45-year-old man who had had many non-tender yellowish-white to reddish papules and nodules on his arms, hands, abdomen, upper back, legs, and feet for 10 years. Owing to the scattered appearance on the non-articular sites, our initial diagnosis was eruptive xanthomatosis with a differential diagnosis of cutaneous gout. A dermoscopic evaluation revealed a homogeneous yellowish-white area with white (bright) dots on the ulcerated sites, which was indicative of cutaneous gout. Histopathological findings showed an amorphous material with needle-like clefts, which confirmed the diagnosis. This case adds evidence to demonstrate the clinical manifestations of disseminated cutaneous miliarial gout and highlights the importance of considering unusual cutaneous tophi in the differential diagnosis of yellowish-white lesions in dermoscopic evaluations.