Tophaceous Gout on Ear Imitating Squamous Cell Carcinoma

Abstract

We report a case of tophaceous gout occurring in a Hispanic 69-year-old immunocompetent man. The patient presented with a 0.8 cm pink, purple, and brown dome-shaped papule on the right superior helix of the ear. The lesion was tender to palpitation. A deep shave biopsy was performed and the histological findings demonstrated pseudoepitheliomatous hyperplasia overlying large dermal deposits of pink, hyalinized feathery material surrounded by mild granulomatous inflammation. This finding supported the diagnosis of tophaceous gout rather than the clinical findings imitating squamous cell carcinoma. Concurrently, the patient received an intralesional Kenalog (ILK) injection to suppress any existing or ensuing inflammation. Treatment of the residual lesion was achieved via curettage and electrodesiccation.

Gout Affecting the Nail Unit: Report of Two Cases and Literature Review

“…Within a shallow shave biopsy, tophi may not be present or small foci may be overlooked. An English language literature search of gouty tophi and SCC yielded an additional eight cases of tophaceous gout mimicking SCC both clinically and histologically (Table 2), the latter of which is attributed to presence of PCH [4][5][6][9][10][11]. Five of the total nine cases involved lesions on the ears while the other four were reported to involve the finger pulp and the PNF.…”