内分泌学とメタボリックシンドローム
オープンアクセス

概要

Chronic Gout Presenting as Whitish Bullae over Palmer Surface of Hand

Kalpalata Tripathy, Aparajita Mishra, Debiprasad Mishra, Smrutirekha Behera and Lity Mohanty

Subcutaneous bullae over the finger can prove to be a challenge to diagnosticians and clinicians as it can mimic several other joint-related lesions. Gouty tophus and its diagnosis can be difficult in cases of atypical presentations. This report describes a case of chronic gout presenting as subcutaneous bullae only over palmer surface of hand, including the cytologic and histologic findings. A 41-year-old male presenting with multiple subcutaneous bullous lesions of 1 year duration came to the cytology out patient department for a Tzanck preparation. Aspiration yielded chalky white material. FNA smears revealed abundant granular amorphous material, and slender needle-like crystals with a granulomatous inflammatory reaction. Histopathologic confirmation was done and serum uric acid level was 16mg/dl. Fine needle aspiration cytology (FNAC) is a valuable diagnostic tool for the diagnosis of gouty tophi, even in cases of unusual presentation and the pathologist should be aware of the cytological features.