IIliev Georgi, Ivanova Polina Petrova, Nedev Plamen, Popov Hristo
From the ENT Department and.
Clinic of General and Clinical Pathology, University Hospital Saint Marina-Varna, Medical Universiry of Varna, Varna, Bulgaria.
Ann Plast Surg. 2019 Jun;82(6):642-645. doi: 10.1097/SAP.0000000000001778.
Gout is a disease characterized by abnormal metabolism of the uric acid, leading to undesired buildup of monosodium urate crystals affecting mainly the first metatarsal-phalangeal joint of the foot and less commonly other joints or the soft tissues of the body. The prevalence of the disease increases with age, and it is statistically more observed in men than in women.We present the case of a 62-year-old male patient diagnosed as having gout 20 years ago. He came to the clinic with a nasal hump and a mass growing in his nose for the last 3 years, presenting as a nasal obstruction and facial deformity. Although the patient was treated with allopurinol and nonsteroidal anti-inflammatory drugs, surgical treatment was deemed necessary, and the patient was taken to receive a surgical resection of the nasal mass. The follow-up histopathology observation revealed deposits of urate crystals surrounded by a granulomatous inflammation. This confirmed the diagnosis-gouty tophi in the nose. In the follow-up period after the surgery, the patient reported overall improved breathing and aesthetic results.Tophi can be found in atypical locations, which increases morbidities and deformities caused by the disease. We report on this peculiar case of tophaceus gout as it is-a rare manifestation of the disease with tophi located in the nasal region.
痛风是一种以尿酸代谢异常为特征的疾病，会导致尿酸钠晶体异常积聚，主要影响足部的第一跖趾关节，较少影响身体的其他关节或软组织。该疾病的患病率随年龄增长而增加，从统计学上看，男性比女性更易患此病。我们报告一例62岁男性患者，20年前被诊断为痛风。他因鼻隆起和鼻腔内肿物3年就诊，表现为鼻塞和面部畸形。尽管患者接受了别嘌醇和非甾体抗炎药治疗，但仍认为有必要进行手术治疗，遂对该患者进行了鼻腔肿物切除手术。术后病理组织学观察显示有尿酸盐晶体沉积，周围有肉芽肿性炎症。这证实了诊断——鼻部痛风石。在手术后的随访期，患者报告呼吸和美观效果总体有所改善。痛风石可出现在非典型部位，这会增加该疾病所致的发病率和畸形。我们如实报告这例特殊的痛风石性痛风病例，因为它是该疾病的一种罕见表现，痛风石位于鼻腔区域。
