PMC5288469_01
Tophaceous gout. Grouped white-to-yellow papules on the finger pads.
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Dermatologic examination found grouped and distributed white-to-yellow milialike papules measuring 2 to 3mm in diameter on the distal finger pads of the index and long fingers, which were tender to palpation (Fig 1).
Radiograph of the hands. A, Soft tissue swelling along with periarticular calcifications at both 1st carpometacarpal joints. There is no digital calcification. B, Calcification in the region of the triangular cartilage on the left and adjacent to the triquetrum and ulnar styloid process of the left hand.
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Radiograph of the hands showed periarticular calcifications at both first carpometacarpal joints and adjacent to the ulnar styloid process, evidence of distal osteoarthritis, and soft tissue swelling of the finger pads without digital calcification (Fig 2).
Tophaceous gout. Amorphous eosinophilic deposits in dermis show characteristic clefting. Original magnifications: A, x10 and B, x20.
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Diagnosis was confirmed by a skin biopsy (Fig 3).