Abstract:
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.
journal_name
Medicine (Baltimore)journal_title
Medicineauthors
Martin D,Joliat GR,Fournier P,Brunel C,Demartines N,Gié Odoi
10.1097/MD.0000000000006733subject
Has Abstractpub_date
2017-04-01 00:00:00pages
e6733issue
16eissn
0025-7974issn
1536-5964pii
00005792-201704210-00072journal_volume
96pub_type
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