Disseminated cutaneous gout: a rare manifestation of gout

A 51-year-old man presented with multiple inflammatory skin lesions on both lower legs that had developed 3 weeks prior. He had a 15-year history of gout and stage 3 chronic kidney disease. Upon physical examination, multiple yellowish, firm papulonodules with evidence of suppuration were noted on his shins, calves, knees, and ankles (Fig. 1). A skin biopsy revealed well-circumscribed deposits of pinkish, amorphous material in the deep dermis, surrounded by histiocytic infiltration and a fibrous reaction. Von Kossa staining did not show any calcium deposition (Fig. 2). The patient was diagnosed with disseminated cutaneous gout, and the skin lesions were treated symptomatically with topical steroids and oral antihistamines. Gout is a chronic disease characterized by the deposition of monosodium urate (MSU) crystals, which form when urate concentrations are elevated [1]. These MSU crystals can accumulate in joints, bones, and various body tissues, including the skin and soft tissues. The disease can be