title: Multiple Cutaneous Creamy Papules and Nodules: A Case of Miliarial Gout.
abstract: BACKGROUND
  Tophaceous gout is the nonarticular deposition of monosodium urate resulting from a disorder in purine metabolism that causes an elevation of serum uric acid. Cutaneous variants of tophaceous gout include papular, nodular, ulcerative, and pustular forms.
  
  
  OBJECTIVE
  We present a case of a 67-year-old man who presented with multiple cutaneous creamy white papules and nodules. A biopsy was taken, and a diagnosis of cutaneous tophaceous gout was made. The treatment and pathophysiology are discussed.
  
  
  CONCLUSIONS
  Miliarial gout is a rare form of cutaneous tophaceous gout that is treated using xanthine oxidase inhibitors such as allopurinol and febuxostat or uricosurics such as probenecid.
authors.affiliation: Department of Dermatology and Skin Science and Division of Rheumatology, Department of Medicine, University of British Columbia, and Division of Dermatology, Department of Medicine, St. Paul's Hospital, Providence Health Care, Vancouver, BC kirchhof.mark@gmail.com.
authors.forename: Mark G
authors.initials: MG
authors.lastname: Kirchhof
authors.affiliation: Department of Dermatology and Skin Science and Division of Rheumatology, Department of Medicine, University of British Columbia, and Division of Dermatology, Department of Medicine, St. Paul's Hospital, Providence Health Care, Vancouver, BC.
authors.forename: David
authors.initials: D
authors.lastname: Collins
authors.affiliation: Department of Dermatology and Skin Science and Division of Rheumatology, Department of Medicine, University of British Columbia, and Division of Dermatology, Department of Medicine, St. Paul's Hospital, Providence Health Care, Vancouver, BC.
authors.forename: Richard I
authors.initials: RI
authors.lastname: Crawford
authors.affiliation: Department of Dermatology and Skin Science and Division of Rheumatology, Department of Medicine, University of British Columbia, and Division of Dermatology, Department of Medicine, St. Paul's Hospital, Providence Health Care, Vancouver, BC.
authors.forename: Sheila
authors.initials: S
authors.lastname: Au
mesh_terms: D000368:Aged; D006073:Gout / Q000175:diagnosis* / Q000473:pathology; D006801:Humans; D008297:Male; D008883:Miliaria / Q000175:diagnosis* / Q000473:pathology; D013848:Thigh / Q000473:pathology