Related Experiment Video
Updated: Nov 9, 2025
11:39
The Goeckerman Regimen for the Treatment of Moderate to Severe Psoriasis
Published on: July 11, 2013
39.2K
Tophaceous Gout - When the Skin Comes First.
Carmen Salavastru1, Fabiola Iuliana Copaci, Daniela Vrinceanu
1Professor Carmen Salavastru, MD, PhD, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania; carmen.salavastru@umfcd.ro.
Acta Dermatovenerologica Croatica : ADC
|April 9, 2021
Summary
Tophaceous gout, characterized by monosodium urate crystal deposits, can be the first sign of gout. Early recognition by dermatologists is crucial for effective management and preventing long-term complications.
Area of Science:
- Rheumatology and Dermatology
- Metabolic disorders
- Crystal-induced arthritis
Background:
- Gout is a metabolic disorder caused by monosodium urate crystal deposition.
- Tophi, or crystal accumulation in connective tissue, typically manifest in the chronic stage, usually after 10 years of disease onset.
- Tophaceous gout as an initial presentation is considered uncommon.
Purpose of the Study:
- To report three cases of tophaceous gout presenting as the initial symptom.
- To highlight the importance of dermatological awareness for early diagnosis and management.
- To underscore the need for investigating underlying causes of hyperuricemia.
Main Methods:
- Case series reporting three patients with painful subcutaneous nodules and hyperuricemia.
- Clinical evaluation, laboratory investigations (including uric acid levels), and histopathology.
- Diagnostic confirmation of gout with tophi as the primary manifestation.
Main Results:
- Three patients (aged 70, 33, and 53) presented with painful subcutaneous nodules due to tophaceous gout.
- All patients exhibited hyperuricemia, necessitating investigation into uric acid metabolism.
- Diagnosis was confirmed via laboratory and pathology findings, with tophi being the initial sign.
Conclusions:
- Tophaceous gout can uncommonly present as the first clinical manifestation of the disease.
- Dermatologists must be aware of this rare presentation for timely diagnosis and intervention.
- Early management, including patient education, lifestyle changes, and medication, led to favorable outcomes and symptom alleviation.
Related Concept Videos
01:25Endocarditis II: Clinical Features of Infective Endocarditis
97
Endocarditis can present various clinical features depending on the causative organism and the patient's underlying health conditions. Initially, the clinical features of infective endocarditis develop gradually, presenting with nonspecific symptoms that can be easily mistaken for other illnesses.General SymptomsEarly symptoms of infective endocarditis are fever, chills, weakness, malaise, fatigue, and weight loss. These symptoms reflect the systemic nature of the infection and the body's...
97
01:23Skin Diseases and Disorders
4.6K
Skin is the first line of defense and encounters a variety of microbes. Some pathogenic strains are often the cause of a broad range of infections of the skin and other body systems. These conditions can affect people of all ages and may have different causes, including genetic factors, infections, autoimmune reactions, environmental factors, and lifestyle choices.
Gram-positive Staphylococcus spp. and Streptococcus spp. are responsible for many of the most common skin infections. However, many...
Gram-positive Staphylococcus spp. and Streptococcus spp. are responsible for many of the most common skin infections. However, many...
4.6K
01:24Chronic Kidney Disease II: Clinical Manifestations
255
Chronic Kidney Disease (CKD) progressively impairs multiple body systems due to the accumulation of uremic toxins, which disrupt cellular functions across various organs.Neurologic symptomsNeurologic symptoms often arise early in CKD, as uremic toxin buildup drives changes in cognitive and motor functions. Patients frequently experience fatigue, headache, confusion, difficulty concentrating, and, in severe cases, seizures. Peripheral neuropathy commonly manifests as burning sensations in the...
255
01:24Nephrotic Syndrome I : Introduction
242
Nephrotic Syndrome is a chronic kidney disorder defined by clinical findings such as severe proteinuria, hypoalbuminemia, hyperlipidemia, and edema. These symptoms result from damage to the glomeruli, the kidney’s filtering units, increasing their permeability to proteins.Definition and Meaning:Proteinuria, defined as the loss of more than 3.5 grams of protein per day in adults, is a crucial feature of nephrotic syndrome. This condition is often accompanied by edema, the accumulation of...
242
01:31Pulmonary Tuberculosis III
573
Tuberculosis (TB) is a contagious infection primarily affecting the lung parenchyma but which can also affect other body parts. TB can be classified based on disease development, presentation, and the affected anatomical site.
The first classification is based on the development of the disease, and it includes the following categories:
The first classification is based on the development of the disease, and it includes the following categories:
573
01:26Nephrotic Syndrome II : Assessment and Medical Management
57
IntroductionNephrotic syndrome is a kidney disorder marked by excessive protein loss in the urine, leading to various systemic complications. This condition often results from damage to the glomeruli—the kidney's filtering units—causing proteinuria, low blood protein levels, and fluid retention. Understanding the assessment, diagnosis, and management of nephrotic syndrome is essential for effective treatment and prevention of further kidney damage.AssessmentPatient History: Document...
57