Chronic tophaceous gout in a patient with a history of allopurinol toxicity.

We present an unusual complication of chronic tophaceous gout in a 63-year-old man with a 27-year history of gout, who could not be treated with allopurinol due to previous allopurinol-induced neutropenia. The patient presented with a progressively enlarging, painful mass on the bottom of his right foot, which caused difficulty wearing shoes and walking. Extirpation of the tophus and first metatarsophalangeal joint arthroplasty were successfully employed for management of this condition.