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Multiple Cutaneous Creamy Papules and Nodules: A Case of Miliarial Gout
Mark G Kirchhof1, David Collins2, Richard I Crawford2
1Department of Dermatology and Skin Science and Division of Rheumatology, Department of Medicine, University of British Columbia, and Division of Dermatology, Department of Medicine, St. Paul's Hospital, Providence Health Care, Vancouver, BC kirchhof.mark@gmail.com.
Background:
Tophaceous gout is the nonarticular deposition of monosodium urate resulting from a disorder in purine metabolism that causes an elevation of serum uric acid. Cutaneous variants of tophaceous gout include papular, nodular, ulcerative, and pustular forms.
Objective:
We present a case of a 67-year-old man who presented with multiple cutaneous creamy white papules and nodules. A biopsy was taken, and a diagnosis of cutaneous tophaceous gout was made. The treatment and pathophysiology are discussed.
Conclusion:
Miliarial gout is a rare form of cutaneous tophaceous gout that is treated using xanthine oxidase inhibitors such as allopurinol and febuxostat or uricosurics such as probenecid.
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