Auricular Gouty Tophi: A Rare Presentation in an Uncommon Site

Unlike the intense redness and painful swollen joint seen in acute gouty arthritis, classically affecting the first metatarsophalangeal joint called podagra, painless gouty tophi nodules can be found in any soft tissue throughout the body. While they frequently affect areas like the toes, fingers, and olecranon bursae, it is rare to see monosodium urate crystal deposits in the facial region, particularly the ear. This case highlights a patient with uncontrolled hyperuricemia, presenting with an uncommon manifestation of gouty tophi on the auricle. The diagnosis of auricular gouty tophi should be the primary consideration in patients with a nodular auricular mass, whitish material, uncontrolled hyperuricemia, and multiple gouty tophi. Although clinical history, examination findings, and biochemical investigations provide important diagnostic clues, definitive confirmation necessitates surgical excision and histopathological analysis.