When Gout Masquerades as Miliaria: A Case Report and Literature Review of an Unusual Cutaneous Manifestation
Main Article Content
Abstract
We report a case of a 35-year-old male miner from Villa de Alvarez, Mexico, with a history of type 2 diabetes, hypertension, gout, and exogenous Cushing’s syndrome due to prolonged dexamethasone use. He presented with disseminated skin lesions, initially misdiagnosed as severe acne, and later found to be cutaneous gout. Physical examination revealed moon face, oral candidiasis, and violaceous striae, with papular and nodular skin lesions on the extremities and abdomen, accompanied by joint involvement and tophi. Blood tests showed elevated uric acid levels (9.5 mg/dL). Skin biopsy confirmed the diagnosis of cutaneous gout with MSU crystal deposits. Treatment with allopurinol resulted in significant improvement in skin lesions. This case highlights the importance of early diagnosis and appropriate treatment in preventing the progression of gout, particularly in patients with unusual cutaneous manifestations.
Article Details
This work is licensed under a Creative Commons Attribution 4.0 International License.
References
I. Shukla R, Vender RB, Alhabeeb A, Salama S, Murphy F. Miliarial gout (a new entity). J Cutan Med Surg [Internet]. 2007;11(1):31–4. Available from: http://dx.doi.org/10.2310/7750.2007.00002
II. Mireku KA, Burgy JR, Davis LS. Miliarial gout: a rare clinical presentation. J Am Acad Dermatol [Internet]. 2014;71(1):e17-8. Available from: http://dx.doi.org/10.1016/j.jaad.2014.01.851
III. Sami F, Sami SA, Arora S. Rare presentation of disseminated gout nodulosis and chronic inflammatory arthritis. Case Rep Rheumatol [Internet]. 2023;2023:8083212. Available from: http://dx.doi.org/10.1155/2023/8083212
IV. Forbess LJ, Fields TR. The broad spectrum of urate crystal deposition: unusual presentations of gouty tophi. Semin Arthritis Rheum [Internet]. 2012;42(2):146–54. Available from: http://dx.doi.org/10.1016/j.semarthrit.2012.03.007
V. Gaviria JL, Ortega VG, Gaona J, Motta A, Medina Barragán OJ. Unusual dermatological manifestations of gout: Review of literature and a case report. Plast Reconstr Surg Glob Open
[Internet]. 2015;3(7):e445. Available from: http://dx.doi.org/10.1097/GOX.0000000000000420
VI. Pradhan S, Sinha R, Sharma P, Sinha U. Atypical cutaneous presentation of chronic tophaceous gout: A case report. Indian Dermatol Online J [Internet]. 2020;11(2):235–Available from:
http://dx.doi.org/10.4103/idoj.IDOJ_205_19
VII. Merdler-Rabinowicz R, Tiosano S, Comaneshter D, Cohen AD, Amital H. Comorbidity of gout and rheumatoid arthritis in a large population database. Clin Rheumatol [Internet]. 2017;36(3):657–60. Available from: