Auricular tophi as the initial presentation of gout

Auricular Multiple Tophi Presenting as Painful Bilateral Nodules: A Case Report and Literature Review

“…18) The head and neck regions involved include the arytenoid, true or false vocal cord, hyoid bone, thyroid cartilage, cricoarytenoid joint, subglottis, soft tissues of the nasal dorsum, nasal septum, temporomandibular joint, soft palate, cervical spine, and glossoepiglottic ligament. 1) Besides hyperuricemia, a low body temperature and reduced blood flow can result in formation of AT. 19) Furthermore, the auricular cartilage might be a predisposing site for tophus formation, similar to that in other joints.…”

“…Gout is a systemic metabolic disease which can manifest as arthritis characterized by uric acid crystal deposition (tophus) around joints and subconnective tissue due to long standing hyperuricemia. 1) Accompanying inflammation can lead to pain, swelling, and redness of the affected joints. Some causal factors that can induce gout include genetic susceptibilities; aging; high nutrition; purinerich diets; being overweight; certain medications like cyclosporine, anti-tuberculosis regimen with pyrazinamide, thiazide, and aspirin; certain medical conditions including uncontrolled hypertension and metabolic syndrome such as diabetes; impaired renal function; and heavy drinking of alcohol or sweetened drinks.…”

“…Some causal factors that can induce gout include genetic susceptibilities; aging; high nutrition; purinerich diets; being overweight; certain medications like cyclosporine, anti-tuberculosis regimen with pyrazinamide, thiazide, and aspirin; certain medical conditions including uncontrolled hypertension and metabolic syndrome such as diabetes; impaired renal function; and heavy drinking of alcohol or sweetened drinks. 1,2) Single joint arthritis at the early stages of gout usually turns into multiple tophi formations in the body within two decades. Most tophi develop in advanced stages of poorly controlled gout and are usually found at the lower extremities such as the toes, ankles, knees, and fingers.…”

Auricular Solitary Gouty Tophus in a Young Adult

“…Deposition of monosodium urate crystals also can occur in the ear as painless auricular gouty tophi, the most common form of gouty tophus occurring in the head and neck region. 2 The auricle, with its supersaturation of blood uric acid due to decreased temperature and reduced blood flow, is prone to develop gouty tophi. Auricular gouty tophi can either present concomitantly with other soft-tissue tophi or develop as a unique and initial sign of gout, as reported in previous literature 2 and in our case.…”

Tophaceous gout of the middle ear

“…Gouty tophi are usually located in the great toe or other affected joints ( Wijnands et al., 2015 ). Ear locations have already widely been reported to the pinna ( Griffin et al., 2009 ) but rarely within the middle ear (ME) ( Forbess and Fields, 2012 ). We report an isolated ME tophaceous gout in an otherwise healthy patient.…”