title: Tophi as first manifestation of gout.
abstract: Chronic tophaceous gout classically occurs after 10 years or more of recurrent polyarticular gout. However, tophi can also occur as first sign of the disorder. Here we report a 20-year-old male presenting with multiple subcutaneous nodules on bilateral feet and toes, left palm, right elbow, helix of left ear since last one and half year prior to any other manifestation of gout. He was having mild intermittent arthritis since last six months. Fine Needle Aspiration Cytology of one tophus showed monosodium urate crystals, which are pathognomonic for gout. His serum uric acid was normal and ultrasound revealed bilateral nephrocalcinosis. So far as we know, this is the first case report from India, demonstrating tophi as the initial clinical presentation of gout.
authors.affiliation: Department of Dermatology, Bankura Sammilani Medical College, West Bengal, India. skoley@gmail.com
authors.forename: Sankha
authors.initials: S
authors.lastname: Koley
authors.forename: Atul
authors.initials: A
authors.lastname: Salodkar
authors.forename: Sanjiv
authors.initials: S
authors.lastname: Choudhary
authors.forename: Arvind
authors.initials: A
authors.lastname: Bhake
authors.forename: Kailash
authors.initials: K
authors.lastname: Singhania
authors.forename: Manoj
authors.initials: M
authors.lastname: Choudhury
mesh_terms: D015210:Arthritis, Gouty / Q000097:blood* / Q000473:pathology*; D044963:Biopsy, Fine-Needle; D002908:Chronic Disease; D003460:Crystallization; D006801:Humans; D007194:India; D008297:Male; D009397:Nephrocalcinosis / Q000097:blood / Q000473:pathology; D012867:Skin / Q000473:pathology*; D040521:Subcutaneous Tissue / Q000473:pathology*; D014527:Uric Acid / Q000097:blood / Q000737:chemistry; D055815:Young Adult
chemical_list: D014527:Uric Acid