Gouty tophi present themselves as firm and skincolored or yellowish papules or nodules with white chalky material. They may appear in any location on the body, but appear most commonly in the interphalangeal joints [1]. Clinically, they may resemble calcinosis cutis, rheumatoid nodules, xanthomas, and panniculitis. They indicate a chronic foreign-body granulomatous response to monosodium urate crystal deposits in the dermis and the subcutaneous tissue, and classically occur with untreated chronic gouty arthritis. Very rarely, in the absence of arthritis, they may be the first clinical sign of gout, which is known as gout nodulosis [2].