Clinical characteristics of infectious ulceration over tophi in patients with gout

OBJECTIVE: The aim of this study was to investigate the clinical characteristics of infectious ulceration over tophi in patients with gout. METHODS: Participants were recruited from the First Affiliated Hospital of Wenzhou Medical University. The clinical characteristics of the patients and wound characteristics were recorded. RESULTS: Of the 38 enrolled patients, 18 were found to have infectious ulceration over tophi. Staphylococcus aureus was the most common pathogen and was identified in nine patients. Patients with infection were significantly older (69.6 vs. 60.1 years) and had a worse quality of life than those without infection. Patients with infection also had a significantly longer ulcer duration (125.6 vs. 54.2 days), larger ulcer size (2.47 vs. 1.99 cm(2)), a higher rate of tissue necrosis in the ulcer bed (55.6% vs. 20.0%), a lower rate of callus at the edge (27.8% vs. 70.0%), and a higher moisture level than did patients without infection. Additionally, patients with infection had significantly delayed wound healing (35.3 vs. 20.3 days) compared with patients without infection. CONCLUSIONS: Older patients with a long ulcer duration and larger ulcer size are more susceptible to infection. Infection can lower patients’ quality of life and delay wound healing.