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 CASE REPORT
Year : 2010  |  Volume : 76  |  Issue : 4  |  Page : 393--396

Tophi as first manifestation of gout


1 Department of Dermatology, Bankura Sammilani Medical College, West Bengal, India
2 Department of Dermatology, J.N.M.C. Sawangi, Wardha, Maharastra, India
3 Department of Pathology, J.N.M.C. Sawangi, Wardha, Maharastra, India
4 Department of Radiology, J.N.M.C. Sawangi, Wardha, Maharastra, India
5 Department of Pathology, Bankura Sammilani Medical College, West Bengal, India

Correspondence Address:
Sankha Koley
Subhankar Sarani, Bankura - 722 101, West Bengal
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0378-6323.66593

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Chronic tophaceous gout classically occurs after 10 years or more of recurrent polyarticular gout. However, tophi can also occur as first sign of the disorder. Here we report a 20-year-old male presenting with multiple subcutaneous nodules on bilateral feet and toes, left palm, right elbow, helix of left ear since last one and half year prior to any other manifestation of gout. He was having mild intermittent arthritis since last six months. Fine Needle Aspiration Cytology of one tophus showed monosodium urate crystals, which are pathognomonic for gout. His serum uric acid was normal and ultrasound revealed bilateral nephrocalcinosis. So far as we know, this is the first case report from India, demonstrating tophi as the initial clinical presentation of gout.






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