The development of tophi in the absence of prior episodes of gouty arthritis is unusual. We hereby present a case of a nonalcoholic, normoglycemic, and normotensive middle-aged man, who presented with multiple nodules distributed bilaterally over the dorsum of hands, feet, and elbow joints without any prior history of arthritis. Serum uric acid level was found to be normal. Histology was consistent with features of tophi. On the basis of clinical and histological findings, the nodules were diagnosed as gouty tophi and the patient was diagnosed with gouty nodulosis. Gouty nodulosis is a very rare presentation of gout and only a few reports exist in the medical literature.
An 18-year-old girl presented with multiple itchy hyperpigmented papules and plaques, along with tense blisters over the lower limbs and buttocks for last 3 months. These papules, plaques, and bullae were mostly localized to preexisting scars. The histopathological findings from papule and bulla were consistent with lichen planus (LP) and bullous pemphigoid, respectively. Direct immunofluorescence (DIF) of perilesional skin around bulla showed linear deposition of IgG and C3. Considering clinical, histopathological and DIF findings, diagnosis of LP pemphigoides (LPP) was made. The preferential localization of LPP lesions over preexisting scars was a very interesting finding in our case an extremely rare instance of the isotopic phenomenon.
Cutis laxa, clinically characterized by loose and pendulous skin related to loss of elastic tissue, is a rare heterogeneous condition. It is classified into congenital and acquired types. We report a case of generalized acquired cutis laxa type 1 in a young man following pruritic urticarial plaques. We have done a brief review of literature.
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