[Miliary palmoplantar gout tophi in a patient with hyperuricemia and chronic renal insufficiency].

Abstract

We report on a woman with palmoplantar whitish-yellowish aggregated, partly ulcerated papules on a slightly erythematous base. Histological examination showed pale amorphous nodular deposits in the dermis. On radiological examination, calcifications could be ruled out. Laboratory tests showed marked hyperuricemia and chronic renal insufficiency. We diagnosed miliary gout (MG) and initiated uric acid-reducing therapy with allopurinol 100 mg/day. First described in 2007, MG presenting with multiple whitish-yellowish papules is a rare intradermal variant of classic gout that is characterized by subcutaneous deposits. Clinically, MG can be confused with other dermatoses, for example, cutaneous calcification or pustular palmoplantar psoriasis.