Panniculitis: another clinical expression of gout

Ochoa, Carlos Darío; Valderrama, Vladimir; Mejía, Jimmy; Rondón, Federico; Villaroya, Natalia; Restrepo, José Félix; Espinoza, Luis R.; Gamarra, Antonio Iglesias

doi:10.1007/s00296-010-1561-8

Cited by 30 publications

(47 citation statements)

References 8 publications

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“…While most of the patients with chronic tophaceous gout present with tophi around the joint, synovium, olecranon, knee and tragus, our patient had multiple tophi deposits all over the skin which were discovered to be called ‘Miliary or Disseminated Cutaneous Gout’ 7 8. Multiple ulcerations and panniculitis were also noted and described 9. These lesions eventually became infected and were misdiagnosed as common skin infection.…”

Section: Discussionmentioning

confidence: 65%

‘Golden Kernels within the skin’: disseminated cutaneous gout

Racaza

Penserga

2013

BMJ Case Reports

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Presented in this paper is a case of a young Filipino man presenting with recurrent acute gouty flares leading to chronic tophaceous gout and unusual cutaneous manifestations (miliary gout, panniculitis, ulcerations). Unusual sites within the body (torso, shoulder, forearms, thigh) revealed multiple urate dermal deposition. Self-medication with steroids eventually led to secondary Cushing's syndrome and eventual emergence of metabolic complications.

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Section: Discussionmentioning

confidence: 65%

‘Golden Kernels within the skin’: disseminated cutaneous gout

Racaza

Penserga

2013

BMJ Case Reports

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“…Gouty parmiculitis was first described in 1977 by Niemi (2), and only 15 cases have been reported since (2)(3)(4)(5)(6)(7)(8). The lower extremities are common presenting sites, but it can occur anywhere.…”

Section: Discussionmentioning

confidence: 97%

Gouty Panniculitis also Involving the Bone Marrow

Choi¹,

Lew²,

Lee³

et al. 2013

Acta Derm Venerol

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Gout is a clinical syndrome presenting with recurrent, painful arthritis caused by deposition of monosodium urate. Urate crystal deposits are usually detected in the synovial membranes, joint capsules, articular cartilage, and periarticular tissue, and, rarely, in extra-articular areas (1). Gouty patiniculitis is characterized by subcutaneous depositions of urate crystals with lobular panniculitis. We report here a case of this rare variant of gout, in a 47-year-old man who also showed characteristic depositions of crystals in the bone marrow. CASE REPORTA 47-year-old man presented with skin-coloured to brownish subcutaneous nodules and plaques on both extremities, both hands, and the joints of the foot for 3^ years. He complained of pain, but denied pruritus or any other symptoms. He had had hypertension and had been treated with isosorbide-5-mononitrate 50 mg, daily for 10 years. In addition, he had undergone haemodialysis for end-stage renal disease for 8 years. He also underwent amputation of all of his toes due to thromboangitis obliterans 2 years previously. He had recently been diagnosed with hypothyroidism and took 100 \ig per day levothyroxine sodium (Synthyroxine®, Darim, Seoul, Korea). On physical examination, multiple, various sized, oval-to-linear, firm, fixed, subcutaneous papules, nodules, and plaques were found (Fig. 1). In addition, his skin showed a sclerotic appearance and his joints were not fully extendable. His red blood cell count was 2.32 X lO'/l and white blood cell count was 2.3 x lOVl, with 74.3% neutrophil segments, mild anaemia and neutropaenia. Blood urea nitrogen and uric acid levels were within normal limits (23 mg/dl and 4.2 mg/dl, respectively, upper normal limit 24 and 4.5 mg/dl, respectively). However, creatinine level was markedly elevated (4.6 mg/dl) and levels of iron and total iron-binding capacity were decreased (38 ng/dl and 95 |ig/dl, respectively). Other haematological and autoimmue markers, including antinuclear antibody, rheumatic factor, antimicrosomal antibody, and extractable nuclear antigen profiles, were not remarkable. A biopsy specimen showed that fine, needle-shaped. Fig.

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“…Ochoa i wsp. uważają, że zapalenie to może być spowodowane zaburzeniem dopływu krwi przez kryształy moczanu sodu, co nasila niedotlenienie tkanki podskórnej i pogłębia proces zapalny [40,42]. Gaviria i wsp.…”

Section: Dnawe Zapalenie Tkanki Podskórnejunclassified

Effects of hyperuricemia on the skin

Owczarczyk‐Saczonek¹,

Krajewska–Włodarczyk²,

Placek³

2017

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StrESzczEniEKwas moczowy jest końcowym produktem metabolizmu puryn, a jego stężenie w surowicy u osób zdrowych wynosi 3-7 mg/dl. Hiperurykemia wiąże się z wyższym ryzykiem wystąpienia incydentów sercowo-naczyniowych, a wzrost stężenia kwasu moczowego, zależny od nieprawidłowych nawyków żywieniowych, jest charakterystyczny dla populacji krajów wysoko rozwiniętych. Hiperurykemia może prowadzić do pojawiania się na skórze różnych zmian chorobowych. Jednocześnie kwas moczowy jest ważnym przeciwutleniaczem, odpowiedzialnym za 2/3 pojemności antyoksydacyjnej organizmu. W pracy przedstawiono zmiany skórne towarzyszące dnie moczanowej (guzki dnawe, "dna prosówkowa", dnawe zapalenie tkanki podskórnej). Dokonano także przeglądu piśmiennictwa i omówiono znaczenie hiperurykemii w łuszczycy. Świadomość i wiedza dermatologów na temat hiperurykemii może wpłynąć na szybsze rozpoznawanie zaburzeń metabolicznych u pacjentów na podstawie oceny skóry. AbStrActUric acid is a final product of purine metabolism, and its concentration in the blood serum of healthy individuals is 3-7 mg/dl. Hyperuricemia is associated with higher cardiovascular risk, and its prevalence related to nutrition profile is characteristic for highly developed societies. It can lead to the appearance of certain skin lesions. On the other hand, uric acid is an important antioxidant, which is responsible for 2/3 of the antioxidant capacity of the body. In this article, the authors present skin lesions associated with gout (tophi, "miliarial gout", gouty panniculitis) and review the data of the literature and discuss the importance of hyperuricemia in psoriasis. Dermatologists' awareness and knowledge about hyperuricemia may favor a faster diagnosis of this metabolic disorder based on skin lesions. WPrOWAdzEniEKwas moczowy (ang. uric acid -UA) jest końco-wym produktem metabolizmu puryn pochodzących z diety, syntezy de novo oraz rozpadu komórek. Puryny są rozkładane przez szereg enzymów, tworzą ksantynę i hipoksantynę, które następnie są utleniane przez oksydazę ksantynową do kwasu moczowego. Stężenie kwasu moczowego w surowicy u osób zdrowych wynosi 3-7 mg/dl (180-420 µmol/l) i jest

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Panniculitis: another clinical expression of gout

Cited by 30 publications

References 8 publications

‘Golden Kernels within the skin’: disseminated cutaneous gout

‘Golden Kernels within the skin’: disseminated cutaneous gout

Gouty Panniculitis also Involving the Bone Marrow

Effects of hyperuricemia on the skin

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