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Fingertip tophi without gouty arthritis
M J López Redondo1, L Requena, M Macía
1Department of Dermatology, Hospital Universitario San Carlos, Madrid, Spain.
Dermatology (Basel, Switzerland)
|January 1, 1993
Summary
This study identifies a distinct subgroup of gout patients, often elderly with hyperuricemia and chronic kidney issues, presenting unusual fingertip tophi without prior acute gout attacks.
Area of Science:
- Rheumatology
- Nephrology
- Dermatology
Background:
- Gout is a common inflammatory arthritis caused by hyperuricemia.
- Tophi, urate crystal deposits, typically form in joints and soft tissues.
- Fingertip tophi without a history of acute gout are rarely reported.
Observation:
- Two elderly patients presented with tophi exclusively on their fingertips.
- Neither patient had a documented history of acute gouty arthritis.
- These cases suggest an atypical presentation of gout.
Findings:
- The identified patient subgroup exhibits hyperuricemia, fingertip tophi, and absence of acute gout history.
- Chronic renal failure and medications/diseases affecting urate excretion were common.
- This presentation may represent a specific phenotype of chronic gout.
Implications:
- Recognizing this fingertip tophi presentation is crucial for diagnosing atypical gout.
- Further research is needed to understand the pathogenesis of this gout subgroup.
- This finding may impact differential diagnosis in elderly patients with fingertip lesions and renal impairment.