Perforating gout of the ear.
Gout is the most common cause of inflammatory arthritis in men over 40 [1]. The prevalence of gout in the US is approximately 3.9%. Tophus is a characteristic sign of gout and results when monosodium urate deposits at the joint, skin, or cartilage. Tophi develop in 12-35% of patients who are diagnosed with gout [2]. We report a case of a 70-year-old man who was diagnosed with squamous cell carcinoma of the helix via shave biopsy. During Mohs micrographic surgery, a vigorous foreign-body reaction was noted. Review of the initial biopsy slides identified crystals with pseudoepitheliomatous hyperplasia (PEH) rendering a diagnosis of gout. This case emphasizes the importance of recognizing causes of PEH and the predilection for tophi to form on the ear.
Baylor Scott & White, 409 W Adams Ave, Temple, TX. leighmsutton@gmail.com.
Leigh
L
Sutton
Palak
P
Parekh
D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis; D003951:Diagnostic Errors; D004427:Ear Diseases / Q000175:diagnosis* / Q000473:pathology; D004428:Ear Neoplasms / Q000175:diagnosis; D005549:Foreign-Body Reaction / Q000175:diagnosis* / Q000473:pathology; D006073:Gout / Q000175:diagnosis* / Q000473:pathology; D006801:Humans; D008297:Male; D012871:Skin Diseases / Q000175:diagnosis* / Q000473:pathology; D012878:Skin Neoplasms / Q000175:diagnosis