title: Miliarial gout (a new entity).
abstract: 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.
authors.affiliation: Department of Medicine, Mcmaster University, Hamilton, ON, Canada.
authors.forename: Rahul
authors.initials: R
authors.lastname: Shukla
authors.forename: Ronald B
authors.initials: RB
authors.lastname: Vender
authors.forename: Ayman
authors.initials: A
authors.lastname: Alhabeeb
authors.forename: Samih
authors.initials: S
authors.lastname: Salama
authors.forename: Frank
authors.initials: F
authors.lastname: Murphy
mesh_terms: 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
chemical_list: D006074:Gout Suppressants; D000493:Allopurinol; D003078:Colchicine