title: Gout with auricular tophi following anti-tuberculosis treatment: a case report.
abstract: BACKGROUND
  Auricular tophi are firm deposits of monosodium urate in crystal form, which may slowly develop in subcutaneous tissue of the ear. Ear is not usual locations for gout tophi, but when this growth does occur, helix and the antihelix are common sites.
  
  
  METHODS
  We present a 64-year-old man who had multiple painless nodules over bilateral helix. An excisional biopsy was performed. Hematoxylin-eosin staining of biopsy specimens revealed a proteinaceous matrix that surrounded dissolved crystals, consistent with gout tophi. Bilateral auricular tophi are not common and may resemble a number of other diseases including squamous cell carcinomas, Kaposi's sarcoma, epidermal and dermoid cysts, rheumatoid nodules. Biopsy should be performed to rule out malignancy.
  
  
  CONCLUSIONS
  Tophi of the auricle are usually asymptomatic but can become inflamed and occasionally ulcerate through the overlying skin. Chronic tophaceous gout is treated with dietary control and medication. Surgical excision is performed under local anesthetic if symptoms progression or cosmetically deformity is concerned.
authors.forename: Hsin-Jen
authors.initials: HJ
authors.lastname: Chang
authors.forename: Pa-Chun
authors.initials: PC
authors.lastname: Wang
authors.forename: Ying-Chieh
authors.initials: YC
authors.lastname: Hsu
authors.affiliation: Department of Pathology, Cathay General Hospital, Taipei, Taiwan. rexamy@gmail.com.
authors.forename: Shih-Hung
authors.initials: SH
authors.lastname: Huang
mesh_terms: D000995:Antitubercular Agents / Q000009:adverse effects*; D001706:Biopsy; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis / Q000473:pathology; D003937:Diagnosis, Differential; D054644:Ear Auricle / Q000473:pathology*; D004814:Epidermal Cyst / Q000175:diagnosis / Q000473:pathology; D006073:Gout / Q000139:chemically induced* / Q000175:diagnosis* / Q000473:pathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D012218:Rheumatoid Nodule / Q000175:diagnosis / Q000473:pathology; D012514:Sarcoma, Kaposi / Q000175:diagnosis / Q000473:pathology; D014397:Tuberculosis, Pulmonary / Q000188:drug therapy; D014527:Uric Acid / Q000378:metabolism*
chemical_list: D000995:Antitubercular Agents; D014527:Uric Acid