Sutton Leigh, Parekh Palak
Baylor Scott & White, 409 W Adams Ave, Temple, TX.
Dermatol Online J. 2016 Oct 15;22(10):13030/qt1vn208xw.
Gout is the most common cause of inflammatory arthritis in men over 40 [1]. The prevalence of gout in the US is approximately 3.9%. Tophus is a characteristic sign of gout and results when monosodium urate deposits at the joint, skin, or cartilage. Tophi develop in 12-35% of patients who are diagnosed with gout [2]. We report a case of a 70-year-old man who was diagnosed with squamous cell carcinoma of the helix via shave biopsy. During Mohs micrographic surgery, a vigorous foreign-body reaction was noted. Review of the initial biopsy slides identified crystals with pseudoepitheliomatous hyperplasia (PEH) rendering a diagnosis of gout. This case emphasizes the importance of recognizing causes of PEH and the predilection for tophi to form on the ear.
痛风是40岁以上男性炎性关节炎最常见的病因[1]。美国痛风的患病率约为3.9%。痛风石是痛风的特征性表现，由尿酸钠沉积在关节、皮肤或软骨处所致。在确诊为痛风的患者中，12% - 35%会出现痛风石[2]。我们报告一例70岁男性患者，经刮除活检诊断为耳廓鳞状细胞癌。在莫氏显微外科手术过程中，发现了强烈的异物反应。复查最初的活检切片发现有伴假上皮瘤样增生（PEH）的晶体，从而诊断为痛风。该病例强调了认识PEH病因以及痛风石在耳部形成倾向的重要性。
