Gouty Tophi: A Squamous Cell Carcinoma Mimicker?

Abstract

This is the first report of gouty tophus of the periungual region presenting as a hyperkeratotic lesion. Initial clinical diagnosis favored SCC and histologic evidence suggested a possible early SCC. This lesion can be confused with digital squamous cell carcinoma. The presence of pseu- docarcinomatous hyperplasia may complicate accurate diagnosis.

Tophaceous gout as a squamous cell carcinoma mimicker

“…Four of 5 cases involved lesions on the ear, 2,3 a relatively common site for gout deposition, and only one reported a lesion in an atypical location, the proximal nail fold of a digit. 4 Four of the 5 patients had a known history of gout, although this was not always realized until after identification of gout in the skin specimen, as in our patient's case.…”

Polyarticular tophaceous gouty arthritis: A case report

“…The tophi formation usually occurs over a mean period of 10 years [16]. Tophi are present commonly as subcutaneous, sharply circumscribed nodular collection of monosodium urate crystals [17] at periarticular site in and around bursae and in soft tissue overlying tendon and cartilage [18][19][20]. The most common locations are skin overlying joints and helix of the ears.…”

Pseudocarcinomatous hyperplasia involving the ear from gout: a diagnostic pitfall

“…In 2002, Dacko et al reported pseudocarcinomatous hyperplasia associated with gout on the finger of an 84‐year‐old man. The patient presented with a hyperkeratotic papule on the lateral proximal nail fold of the left fifth digit with resulting nail dystrophy.…”