Multiple gouty tophi in a six-year-old.

Area of Science:

• Pediatric Rheumatology
• Dermatopathology
• Orthopedic Surgery

Background:

• Gouty tophus is exceptionally rare in children, with limited documented cases.
• This report details an unusual presentation of gouty tophus in a pediatric patient.

Observation:

• A 6-year-old child presented with a two-year history of multiple, painful subcutaneous swellings on her lower limbs, causing difficulty walking.
• Initial diagnosis was soft tissue swelling; however, excisional biopsy and histological examination confirmed gouty tophus.

Findings:

• Histological examination of excised masses confirmed the diagnosis of gouty tophus.
• The child was treated with oral febuxostat, resulting in significant clinical improvement.
• Continuous follow-up is ongoing at the pediatric orthopedic outpatient clinic.

Implications:

• A high index of suspicion is crucial for early diagnosis of gouty tophus in pediatric patients, especially those of preschool age.
• Prompt identification and management can minimize potential complications associated with gouty tophus in children.
• This case broadens the understanding of gouty tophus presentation in younger populations.