Abstract
We report here a rare case of enormous gouty tophus with skin necrosis. In 2005, a 43 year-old Japanese man presented with 2 large, firm subcutaneous masses at his left ankle joint. He had complained of pain in his great toe for 10 years, which had been diagnosed as gout, but not treated systemically. He reported that the masses at his left ankle developed 1.5 years before surgery. Despite the enormous lump with skin necrosis in the lateral aspect of his left ankle joint, he could walk painlessly and smoothly. The clinical findings revealed masses in the lateral, medial and anterior aspects of the left ankle joint. The size of the lateral mass was 10×10×2 cm and the medial mass was 5×3×1.5cm. The area of skin necrosis on the lateral mass was 5×4 cm. When the masses were surgically excised, all of them were found to be connected under the skin. Histological appearances were consistent with gouty tophi. The lateral wound was not closed completely, and wet dressing treatment was continued. At 8 weeks after surgery, the wound had healed.
