Kuang Joo Lee, Abd Mutalib Nor Shahida, Abu Backer Farveen Marican, Abdull Rasid Nurul Syeha, Samsuri Hawairy, Hashim Noor Dina
Otorhinolaryngology - Head and Neck Surgery, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, MYS.
Otorhinolaryngology - Head and Neck Surgery, Hospital Sultan Abdul Halim, Sungai Petani, MYS.
Cureus. 2025 Mar 23;17(3):e81035. doi: 10.7759/cureus.81035. eCollection 2025 Mar.
Unlike the intense redness and painful swollen joint seen in acute gouty arthritis, classically affecting the first metatarsophalangeal joint called podagra, painless gouty tophi nodules can be found in any soft tissue throughout the body. While they frequently affect areas like the toes, fingers, and olecranon bursae, it is rare to see monosodium urate crystal deposits in the facial region, particularly the ear. This case highlights a patient with uncontrolled hyperuricemia, presenting with an uncommon manifestation of gouty tophi on the auricle. The diagnosis of auricular gouty tophi should be the primary consideration in patients with a nodular auricular mass, whitish material, uncontrolled hyperuricemia, and multiple gouty tophi. Although clinical history, examination findings, and biochemical investigations provide important diagnostic clues, definitive confirmation necessitates surgical excision and histopathological analysis.
与急性痛风性关节炎中出现的强烈发红和疼痛肿胀的关节不同，典型地影响称为足痛风的第一跖趾关节，无痛性痛风石结节可在全身任何软组织中发现。虽然它们经常影响脚趾、手指和鹰嘴滑囊等部位，但在面部区域，特别是耳部，很少见到尿酸钠晶体沉积。本病例突出了一名高尿酸血症控制不佳的患者，其耳廓出现了痛风石这一罕见表现。对于有耳廓结节性肿物、白色物质、高尿酸血症控制不佳和多发痛风石的患者，应首先考虑耳廓痛风石的诊断。虽然临床病史、检查结果和生化检查提供了重要的诊断线索，但明确诊断需要手术切除和组织病理学分析。
