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A Case Study of Tophaceous Gout: Disfiguring and Disabling

Sadighi, Tammy

Journal of the Dermatology Nurses’ Association: November/December 2015 - Volume 7 - Issue 6 - p 343–346
doi: 10.1097/JDN.0000000000000171

ABSTRACT Tophaceous gout, presenting as nodules on the skin, is uncommon and can be mistaken for neoplasms. These nodules may not be recognized as gout because the clinical diagnosis of tophi gout is not always straightforward with typical symptoms. The cause for tophi gout is elevated serum uric levels, which result from decreased renal excretion, excessive production of urate, and a diet of purine-rich foods. Complications from tophi crystals may occur and can lead to secondary infections, decreased functionality of movement, and disfigurement. Patients need to be treated for acute attacks with complete resolution before long-term treatment is initiated to prevent an increase in the inflammatory cascade. Medications are effective in lowering urate levels and dissolving tophi, but the addition of dietary restrictions is also important to prevent reoccurrence of tophi crystals. Educating patients on early treatment of acute attacks and chronic treatment of high urate levels, along with dietary modification, lessens the possibility of complications that can occur from tophaceous gout.

Tammy Sadighi, DNP, ARNP-FNP, MBA, Florida Gulf Coast University, Fort Myers, FL.

The author declares no conflict of interest.

Correspondence concerning this article should be addressed to Tammy Sadighi, DNP, ARNP-FNP, MBA, Florida Gulf Coast University, 10501 FGCU Boulevard South, Fort Myers, FL 33965. E-mail:

Copyright © 2015 by the Dermatology Nurses' Association.