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An unusual location of gouty panniculitis: A case report

RATIONALE: Gouty panniculitis, characterised by the deposition of monosodium urate crystals in subcutaneous tissue, is a rare clinical manifestation of gout. PATIENT CONCERNS: The case of a 67-year-old man is reported, who presented an erythematous nodule on the upper part of the right buttock suspi...

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Detalles Bibliográficos
Autores principales: Martin, David, Joliat, Gaëtan-Romain, Fournier, Pierre, Brunel, Christophe, Demartines, Nicolas, Gié, Olivier
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer Health 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5406107/
https://www.ncbi.nlm.nih.gov/pubmed/28422890
http://dx.doi.org/10.1097/MD.0000000000006733
Descripción
Sumario:RATIONALE: Gouty panniculitis, characterised by the deposition of monosodium urate crystals in subcutaneous tissue, is a rare clinical manifestation of gout. PATIENT CONCERNS: The case of a 67-year-old man is reported, who presented an erythematous nodule on the upper part of the right buttock suspicious for an abscess. This was in the context of chemotherapy for non-Hodgkin's lymphoma. DIAGNOSES: Histopathologic examination demonstrated gouty panniculitis. INTERVENTIONS: Because infection was suspected, an incision was performed. The lesion was found to be densely calcified and friable, without purulent discharge. Therefore, a surgical en-bloc resection was performed. OUTCOMES: The wound healed slowly initially due to a combination of malnutrition, chemotherapy and infection. A wound infection with Enterococcus faecium was treated with antibiotic therapy (carbapenem for seven days) and local therapy. At 6-week follow up the wound showed good granulation tissue and was healing well by secondary intention. The patient was instructed to continue anti-hyperuricaemic treatment. LESSONS SUBSECTIONS: In patients known to have long-standing hyperuricaemia and gout with nonspecific subcutaneous erythematous nodules, gouty panniculitis should be considered.