Clinical characteristics and risk factors of ulceration over tophi in patients with gout

Abstract

Objectives To describe clinical characteristics of ulceration over tophi in patients with gout and determine risk factors associated with ulceration. Methods Patients presenting with tophi or ulceration(s) over tophi were prospectively recruited and their clinical characteristics were recorded. Comparison of clinical characteristics and risk factors for ulceration were analyzed between groups. Results A total of 105 patients were enrolled. Thirty‐three patients with ulcerations were older, with prolonged duration with gout and tophi, a higher rate of obesity, greater numbers of tophi, lower levels of glomerular filtration rate (GFR), and higher levels of serum creatinine, erythrocyte sedimentation rate and C‐reactive protein. The mean duration of ulceration was 1.63 ± 2.32 months. The ulcerations were mainly located in the ankle (34.21%) and metatarsophalangeal joints (39.47%), with a mean size of 32.37 × 22.76 mm. The majority of ulcerations were categorized as stage I (42.4%) and stage II (51.5%). In univariate regression analysis, age, glucocorticoid overuse, gout duration, tophi duration, tophi number and GFR were associated with ulceration. In the multivariable model, significant differences were demonstrated in glucocorticoid overuse, tophi duration, tophi number. Conclusions Gout patients with ulceration(s) over tophi present several different aspects of clinical characteristics compared with those without ulceration. The ulcerations are most commonly seen in feet and they are mainly categorized as stages I and II. Glucocorticoid overuse, prolonged duration with tophi and greater numbers of tophi are risk factors for ulceration over tophi.

Analysis of Risk Factors for Changes in the Renal Two-Dimensional Image in Gout Patients

“…If the blood creatinine value is higher than the normal value, it indicates kidney damage; therefore, the blood CREA level can more accurately reflect renal parenchymal damage. 27,28 Our research found that the higher the CREA level, the higher the risk of renal cortex thinning in gout patients, suggesting that in the clinical diagnosis and treatment process, we could indirectly predict renal function impairment through the US changes in the renal cortex. In contrast, we could also use the blood CREA level to predict the related changes in the renal cortex indirectly.…”

Limb salvage and systemic management of gouty tophi: Case series

“…Glucocorticoid overuse, prolonged duration of tophi, and greater numbers of tophi are risk factors for ulceration in patients with gouty tophi. [ 10 ] The purpose of surgical treatment is to improve function, relieve pain, improve appearance, remove sinus tract and reduce tophi deposition. [ 11 ] In Case 2, we attempted surgical resection and bone cement implantation for a giant gouty tophi that severely affected function.…”

Clinical Characteristics and Factors associated with Bone Erosion in Gout Patients with Tophi

“…There had been many previous studies on the field of formation mechanism of tophi, clinically relevant risk factors, ulceration associated with tophaceous [15][16][17][18][19]. In recent years, bone destruction due to gout has attracted much attention gradually [20][21][22][23].…”