title: Nodular mucinosis in Graves disease mimicking gouty tophi.
abstract: We report a patient who had Graves disease and recently developed subcutaneous nodules over both lower limbs. Initially, gouty tophi were suspected by the endocrinologist so he was referred to the rheumatology clinic. However, a series of studies, including soft tissue ultrasonography, magnetic resonance image, and biopsy revealed nodular mucinosis resulting from Graves dermopathy. Nodular mucinosis is an unusual form of myxedema which mimics tophaceous gout, and should be considered in patients with Graves disease presenting with subcutaneous nodules.
authors.affiliation: Division of Allergy, Immunology and Rheumatology, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan.
authors.forename: Yi-Ming
authors.initials: YM
authors.lastname: Chen
authors.forename: Hsin-Hua
authors.initials: HH
authors.lastname: Chen
authors.forename: Jong-Liang
authors.initials: JL
authors.lastname: Lan
authors.forename: Der-Yuan
authors.initials: DY
authors.lastname: Chen
authors.forename: Wayne H H
authors.initials: WH
authors.lastname: Sheu
mesh_terms: D001706:Biopsy; D003937:Diagnosis, Differential; D006073:Gout / Q000175:diagnosis* / Q000473:pathology; D006111:Graves Disease / Q000150:complications*; D006801:Humans; D007866:Leg / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D017520:Mucinoses / Q000175:diagnosis* / Q000209:etiology* / Q000473:pathology; D012867:Skin / Q000473:pathology; D014463:Ultrasonography