Disseminated cutaneous tophi in a patient with chronic tophaceous gout and renal impairment: A case report of a rare manifestation of gout

Faisal Parlindungan, Bambang Setyohadi, Riesye Arisanti

Research output: Contribution to journalArticlepeer-review

Abstract

Objective: Rare disease Background: Gout is a metabolic disease characterized by deposition of monosodium urate (MSU) crystals called tophi. The typical location of tophi is in the joint and will chronically damage the joint. However, there is a rare atypical dermatologic manifestation of tophi that occur extensively in the skin. Case Report: A 46-year-old male presented with acute pain in multiple joints. He had a history of gouty arthritis with recurrence attacks, in the past 2 years ago. Over time, he had gradual eruption of multiple tophi and multiple yel-lowish nodules under his skin which sometimes would ulcerate. Laboratory value showed creatinine 2.3 mg/dL and uric acid 11.5 mg/dL. Ultrasound of the kidney showed nephrocalcinosis appearance. Urate crystal was identified in skin biopsy of the nodules. We diagnosed the patient with chronic tophaceous gout with extensive cutaneous involvement. Given the renal impairment, we gave methylprednisolone 3 doses of 8 mg for 5 days then tapered off, colchicine 0.5 mg every other day and allopurinol 1 dose of 100 mg. The patient had dramatic improvement of his pain and is now being followed up regularly. Conclusions: We describe a rare and severe extensive cutaneous manifestation in a chronic tophaceous gout patient.

Original languageEnglish
Article numbere919349
JournalAmerican Journal of Case Reports
Volume21
DOIs
Publication statusPublished - 1 Jan 2020

Keywords

  • Chronic
  • Gout
  • Renal insufficiency
  • Uric acid

Fingerprint

Dive into the research topics of 'Disseminated cutaneous tophi in a patient with chronic tophaceous gout and renal impairment: A case report of a rare manifestation of gout'. Together they form a unique fingerprint.

Cite this