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A case of pseudogout.

K Usuki1, M Yamashita, T Kanzaki

  • 1Department of Dermatology, Kagoshima University Faculty of Medicine, Japan.

The Journal of Dermatology
|May 29, 2000
PubMed
Summary

This case report details a pseudogout attack presenting as synovitis and panniculitis. Diagnosis was confirmed by calcium pyrophosphate dihydrate (CPPD) crystals in synovial fluid.

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Area of Science:

  • Rheumatology
  • Dermatology
  • Crystal-induced Arthropathies

Background:

  • Pseudogout, or calcium pyrophosphate dihydrate (CPPD) crystal deposition disease, commonly affects elderly individuals.
  • It often presents with acute monoarticular arthritis, mimicking gout.
  • Dermatological manifestations are less commonly reported in the context of pseudogout.

Observation:

  • A 56-year-old Japanese male experienced an acute gout-like attack affecting his right wrist.
  • Symptoms included synovitis and panniculitis, without elevated uric acid levels (hyperuricemia).
  • Synovial fluid analysis revealed the presence of calcium pyrophosphate dihydrate (CPPD) crystals.

Findings:

  • The patient was diagnosed with pseudogout based on clinical presentation and crystal identification.
  • The acute attack resolved within two days following treatment with 30 mg of prednisolone.
  • This case highlights an unusual presentation of pseudogout with prominent dermatological involvement.

Implications:

  • This case underscores the importance of considering pseudogout in the differential diagnosis of acute inflammatory arthritis, even with atypical presentations.
  • The co-occurrence of synovitis and panniculitis warrants further investigation into the spectrum of pseudogout manifestations.
  • Reporting such cases in dermatological literature can enhance awareness among dermatologists regarding crystal-induced arthropathies.

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