Disseminated cutaneous gout: a rare manifestation of a common disease

An uncommon presentation of cutaneous dissemination of gout

“…Cutaneous dissemination is a rare, severe manifestation of gout. 2 , 3 Such cases generally present with widespread papulonodules and ulcers involving extraarticular sites. This contrasts with classic tophi, which typically involves cartilage, tendons, and periarticular soft tissue.…”

“…Rarely, it may present as disseminated cutaneous papulonodules and/or ulcerations. 1 , 2 Here, we present a case of disseminated gout with unique cutaneous morphologies and hyperuricemia, which may have been contributing to systemic comorbidities.…”

From skin to microscope, case report of a rare manifestation of tophaceous gout: Miliary gout

“…Skin biopsy should be fixed in alcohol rather than formalin in order to avoid crystal dissolution, as in our case. 6,10 Under such conditions, the crystals appear as an amorphous material with a sharp shape, surrounded by a granulomatous inflammatory reaction rich in histiocytes and lymphocytes. 11 Another way to show the presence of MSU crystals is to collect the chalky material coming out of skin lesions and observe it under a microscope.…”

“…Differential diagnoses include infectious cellulitis, acne, disseminated calcinosis, eruptive xanthomas, osteoma cutis, rheumatoid nodules, and foreign body granulomas. [9][10][11] Ultrasound analysis can help differentiate gouty lesions from other lesions. Contrary to the differential diagnoses, in the case of a tophus, ultrasonography shows a hyperechogenic aggregate typical of gout.…”

Disseminated cutaneous gout

“…Cutaneous disseminated gout is a rare, atypical presentation of MSU crystal deposition disease (gout),1 in which lesions manifest as milia-like papules and eruptions 2. Its presence implies a greater burden of MSU, thus requiring early treatment with hypouricemic agents in a similar approach of that of tophaceous gout 3…”