title: Acute overnight painful swelling of a finger.
abstract: Gouty tophus represents &#1072; specific clinical substrate of &#1072; specific metabolic disease which requires specific treatment in order to reduce the levels of serum urate. Although curable, the painful tophi enlarge slowly and the time-depending response to the standard anti-gout therapy is longer, which significantly worsens the quality of life of those patients. We present the case of a patient with painful gouty tophus, which was eradicated by a micro invasive surgical technique, leading to an immediate positive effect on the pain symptoms. The performance of surgical techniques for excision of gouty tophus should be considered in all patients with strongly pronounced painful symptoms as well as those who show functional disorders caused by the painful swellings. Although not specific for this disease, the application of this therapeutic option produces substantial and immediate improvement of the painful symptoms and the quality of life of these patients.
authors.affiliation: Onkoderma Policlinic for Dermatology, Venereology and Dermatologic Surgery, Sofia, Bulgaria.
authors.forename: A A
authors.initials: AA
authors.lastname: Chokoeva
authors.affiliation: Policlinic for Dermatology and Venereology, University Hospital Lozenetz, Sofia, Bulgaria.
authors.forename: G
authors.initials: G
authors.lastname: Tchernev
authors.affiliation: Department of Pathology and Dermatology, University of Virginia Health System, Charlottesville, VA, USA.
authors.forename: J W
authors.initials: JW
authors.lastname: Patterson
authors.affiliation: Professor and Chair of Dermatology, University of Rome "G. Marconi", Rome, Italy.
authors.forename: T
authors.initials: T
authors.lastname: Lotti
authors.affiliation: Department of Dermatology and Allergology Hospital Dresden-Friedrichstadt, Academic Teaching Hospital of the Technical University of Dresden, Dresden, Germany.
authors.forename: U
authors.initials: U
authors.lastname: Wollina