Risk factors for ulceration over tophi in patients with gout

Xu, Jianjun; Cai, Lin; Zhang, Peng; Ying, Jianghui

doi:10.1111/iwj.12680

Cited by 11 publications

(8 citation statements)

References 19 publications

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“…However, our finding suggested that serum urate, gout duration and GFR were not risk factors for tophi ulceration. This is in accordance with the previous study . Meanwhile, our study also did not demonstrated age as an independent risk factor for ulceration over tophi, which was not consistent with the previous study, although patients with ulcerations were older in our study.…”

Section: Discussionsupporting

confidence: 80%

Clinical characteristics and risk factors of ulceration over tophi in patients with gout

Huang

Liu

et al. 2019

Int J of Rheum Dis

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Objectives To describe clinical characteristics of ulceration over tophi in patients with gout and determine risk factors associated with ulceration. Methods Patients presenting with tophi or ulceration(s) over tophi were prospectively recruited and their clinical characteristics were recorded. Comparison of clinical characteristics and risk factors for ulceration were analyzed between groups. Results A total of 105 patients were enrolled. Thirty‐three patients with ulcerations were older, with prolonged duration with gout and tophi, a higher rate of obesity, greater numbers of tophi, lower levels of glomerular filtration rate (GFR), and higher levels of serum creatinine, erythrocyte sedimentation rate and C‐reactive protein. The mean duration of ulceration was 1.63 ± 2.32 months. The ulcerations were mainly located in the ankle (34.21%) and metatarsophalangeal joints (39.47%), with a mean size of 32.37 × 22.76 mm. The majority of ulcerations were categorized as stage I (42.4%) and stage II (51.5%). In univariate regression analysis, age, glucocorticoid overuse, gout duration, tophi duration, tophi number and GFR were associated with ulceration. In the multivariable model, significant differences were demonstrated in glucocorticoid overuse, tophi duration, tophi number. Conclusions Gout patients with ulceration(s) over tophi present several different aspects of clinical characteristics compared with those without ulceration. The ulcerations are most commonly seen in feet and they are mainly categorized as stages I and II. Glucocorticoid overuse, prolonged duration with tophi and greater numbers of tophi are risk factors for ulceration over tophi.

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Section: Discussionsupporting

confidence: 80%

Clinical characteristics and risk factors of ulceration over tophi in patients with gout

Huang

Liu

et al. 2019

Int J of Rheum Dis

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“… 16 , 17 In our recent study of risk factors for ulceration over tophi in patients with gout, 77.8% of 113 patients had ulceration on the foot, and friction was the major cause of tophi ulceration. 21 In the present study, patients with infection had a significantly longer ulcer duration and larger ulcer size than those without infection, indicating that both a longer ulcer duration and larger ulcer size may be risk factors for infectious ulceration over tophi in patients with gout.…”

Section: Discussionsupporting

confidence: 45%

Clinical characteristics of infectious ulceration over tophi in patients with gout

Zhu

Zhang

2018

J Int Med Res

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ObjectiveThe aim of this study was to investigate the clinical characteristics of infectious ulceration over tophi in patients with gout.MethodsParticipants were recruited from the First Affiliated Hospital of Wenzhou Medical University. The clinical characteristics of the patients and wound characteristics were recorded.ResultsOf the 38 enrolled patients, 18 were found to have infectious ulceration over tophi. Staphylococcus aureus was the most common pathogen and was identified in nine patients. Patients with infection were significantly older (69.6 vs. 60.1 years) and had a worse quality of life than those without infection. Patients with infection also had a significantly longer ulcer duration (125.6 vs. 54.2 days), larger ulcer size (2.47 vs. 1.99 cm2), a higher rate of tissue necrosis in the ulcer bed (55.6% vs. 20.0%), a lower rate of callus at the edge (27.8% vs. 70.0%), and a higher moisture level than did patients without infection. Additionally, patients with infection had significantly delayed wound healing (35.3 vs. 20.3 days) compared with patients without infection.ConclusionsOlder patients with a long ulcer duration and larger ulcer size are more susceptible to infection. Infection can lower patients’ quality of life and delay wound healing.

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“…They found that 13.7% of the patients in this population had clinically apparent ulceration over the tophus, 78% of which were located on the feet. The study also found that ulceration of tophi was independently correlated with older age, increased size of tophi, and a lack of protective sensation [5].…”

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confidence: 61%