Related Experiment Videos
Gouty tophi: a squamous cell carcinoma mimicker?
Anne Dacko1, Kathleen Hardick, Patricia McCormack
1Department of Dermatology, Beth Israel Medical Center New York, New York 10003, USA.
Summary
A gouty tophus presented as a hyperkeratotic digital lesion, mimicking squamous cell carcinoma (SCC). This first-time report highlights the diagnostic challenge, emphasizing the need for thorough histopathology to differentiate from digital malignancies.
Area of Science:
- Dermatology
- Rheumatology
- Oncology
Background:
- Digital lesions have a wide differential diagnosis, with squamous cell carcinoma (SCC) being the most common malignancy.
- Persistent digital lesions causing nail dystrophy require exclusion of SCC.
Observation:
- An 84-year-old man presented with a periungual hyperkeratotic lesion on his left fifth digit, causing nail dystrophy.
- Initial biopsy suggested malignancy, but further examination revealed a gouty tophus.
Findings:
- The gouty tophus mimicked squamous cell carcinoma (SCC) clinically and on initial histopathology.
- Pseudocarcinomatous hyperplasia complicated the diagnostic accuracy.
- This is the first reported case of a periungual gouty tophus presenting as a hyperkeratotic lesion.
Implications:
- Gouty tophi should be considered in the differential diagnosis of hyperkeratotic digital lesions.
- Accurate diagnosis is crucial to avoid misclassification as digital squamous cell carcinoma (SCC).
- This case underscores the importance of comprehensive histopathological evaluation for digital lesions.