PMC7362275_01
Finger pad tophi with ulceration.
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A white chalky discharge from the ulcer was noted (Fig. 1).
T1- and T2-weighted MRI showing a hypointense lesion in the subcutaneous plane.
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T2-weighted soft tissue lesion in a superficial plane to the bone and tendons (Fig. 2). The discharge culture was sterile. The serum uric acid measured 10.2 mg/dl and the patient was referred to the rheumatological department for further evaluation and to initiate medical management.
Excision of the lesion. The lesion is noted firmly incorporated within the soft tissue (A); excised tissue (B); the remaining soft tissue bed studded with fine residual crystals (C); full-thickness skin graft coverage (D).
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The graft was dressed with bolster dressing (Figs. 3A-3C).
Six month follow-up showing well-settled graft and full functional recovery.
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The patient resumed full use of his thumb and daily activity (Fig. 4).