Miliarial gout (a new entity).
BACKGROUND
Tophaceous gout typically presents as a subcutaneous, nodular collection of monosodium urate crystals sharply circumscribed from surrounding tissues. Although intradermal cutaneous manifestations of gout have been described, no reported cases of miliarial gout remain.


OBJECTIVE
We describe the first known presentation of miliarial gout and list other uncommon cutaneous manifestations of gouty tophi. The treatment of miliarial gout is discussed, as well as risk factors predisposing an individual to the development of intradermal tophi.


RESULTS
Miliarial gout is an intradermal phenomenon consisting of multiple tiny papules containing material of a white to cream color scattered on an erythematous base that responds to allopurinol administration. Risk factors predisposing an individual to the development of intradermal gout include renal insufficiency, hypertension, chronic diuretic therapy, long duration of disease, and lack of consistent use of urate-lowering therapy.


CONCLUSIONS
Miliarial gout is a unique intradermal manifestation of tophaceous gout.
Shukla
Rahul
R
Department of Medicine, Mcmaster University, Hamilton, ON, Canada.
Vender
Ronald B
RB
Alhabeeb
Ayman
A
Salama
Samih
S
Murphy
Frank
F
D000368:Aged; D000493:Allopurinol / Q000627:therapeutic use; D003078:Colchicine / Q000627:therapeutic use; D006073:Gout / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology; D006074:Gout Suppressants / Q000627:therapeutic use; D006801:Humans; D008297:Male
D006074:Gout Suppressants; D000493:Allopurinol; D003078:Colchicine