Conflict of interest: none declared.
Clinical dermatology ● Concise report
Unilateral milia-type intradermal tophi associated with underlying urate subcutaneous deposition: an uncommon cutaneous presentation of gout
Article first published online: 10 JUL 2013
© 2013 British Association of Dermatologists
Clinical and Experimental Dermatology
Volume 38, Issue 6, pages 622–625, August 2013
How to Cite
Aguayo, R. S., Baradad, M., Soria, X., Abal, L., Sanmartín, V., Egido, R., Gallel, P., Casanova, J. M. and Martí, R. M. (2013), Unilateral milia-type intradermal tophi associated with underlying urate subcutaneous deposition: an uncommon cutaneous presentation of gout. Clinical and Experimental Dermatology, 38: 622–625. doi: 10.1111/ced.12084
- Issue published online: 10 JUL 2013
- Article first published online: 10 JUL 2013
- Manuscript Accepted: 3 OCT 2012
Tophi develop during the most advanced clinical stage of gout, and are usually located on or around the joints. However, unusual skin features caused by intradermal and/or subcutaneous deposition of tophaceous material at locations other than articular regions have been reported. We present the case of a patient with a condition that has been recently termed ‘miliarial gout’. which is only the second such case, to our knowledge. A 51-year-old woman, who had a chronic joint disease that had been diagnosed and treated as psoriatic arthritis, presented with multiple asymptomatic, yellowish-white, firm papules (1–3 mm in size) on erythematous areas on the outside of her left leg. On histological examination of a skin biopsy, uric acid crystals were seen in the dermis and subcutis. The patient also had a raised level of serum urate, consistent with a diagnosis of gout. Treatment with allopurinol led to rapid improvement. Intake of corticosteroids and diuretics was a possible triggering factor for the development of cutaneous tophi in this patient.