By Gary M. White, MD
In gout, defective uric acid metabolism causes deposition of uric acid crystals in the joints and occasionally the skin.
Gout may present as painful, whitish-yellow nodules on the fingers, elbows, ears or elsewhere. Acute involvement of the toe may cause great pain. There may be drainage of a thin white milky fluid. Cutaneous lesions are also known as tophi. They usually appear within or around joints and on the ears. Tophi may be the first manifestation of gout. Rare forms are militarism gout (tiny miliarial-type papules on an erythematous base) and gouty panniculitis.
Referral to a specialist is in order. Allopurinol and colchicine can improve or clear skin lesions [Clin and Exp Derm 2013;38;622].
Two different patients with very similar presentations of lesions about the knuckles and elbow.
Gouty tophus of the ear before and after biopsy.
Gouty typhus of the ear in a black patient.
Dramatic, multiple large nodules. Dermatology Online Journal 21(1).
Acute swelling of toe for one week. Indian Dermatol Online J. 2014 Dec; 5(Suppl 2): S134–S135
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