Department of Dermatology, Bankura Sammilani Medical College, West Bengal, India.
Indian J Dermatol Venereol Leprol. 2010 Jul-Aug;76(4):393-6. doi: 10.4103/0378-6323.66593.
Chronic tophaceous gout classically occurs after 10 years or more of recurrent polyarticular gout. However, tophi can also occur as first sign of the disorder. Here we report a 20-year-old male presenting with multiple subcutaneous nodules on bilateral feet and toes, left palm, right elbow, helix of left ear since last one and half year prior to any other manifestation of gout. He was having mild intermittent arthritis since last six months. Fine Needle Aspiration Cytology of one tophus showed monosodium urate crystals, which are pathognomonic for gout. His serum uric acid was normal and ultrasound revealed bilateral nephrocalcinosis. So far as we know, this is the first case report from India, demonstrating tophi as the initial clinical presentation of gout.
慢性痛风石性痛风通常在反复发作的多关节痛风 10 年或更长时间后发生。然而，痛风石也可能作为该疾病的首发症状出现。在这里，我们报告了一名 20 岁男性，在出现痛风的任何其他表现之前的一年半时间里，双侧足部和脚趾、左手掌、右肘部、左耳轮出现多个皮下结节。他在过去六个月里一直有轻微的间歇性关节炎。一个痛风石的细针抽吸细胞学检查显示单钠尿酸盐晶体，这是痛风的特征性表现。他的血清尿酸正常，超声显示双侧肾钙质沉着症。据我们所知，这是印度首例报告，表明痛风石是痛风的初始临床表现。
