Quiz-summary
0 of 1 questions completed
Questions:
- 1
Information
Presented by George Netto, M.D. and prepared by Zarir E. Karanjawala, M.D., Ph.D.
Case 1: 45 year old male with a long standing history of arthritis and advanced renal failure.
You have already completed the quiz before. Hence you can not start it again.
Quiz is loading...
You must sign in or sign up to start the quiz.
You have to finish following quiz, to start this quiz:
Results
Time has elapsed
Categories
- Not categorized 0%
- 1
- Answered
- Review
-
Question 1 of 1
1. Question
Week 331: Case 1
45 year old male with a long standing history of arthritis and advanced renal failure presented with multiple skin nodules in the abdominal wall region./images/netto111207_1A.jpg
/images/netto111207_1b.jpg
/images/netto111207_1c.jpg
/images/netto111207_1d.jpg
/images/netto111207_1e.jpgCorrect
Answer: Tophaceous gout
Histology: Amorphus eosinophilic material is seen deposited in the deep reticular dermis and subcutis. Surrounding giant cell foreign body reaction with mild lymphoplasmacytic infiltrate is present. The deposits are composed of needle shaped crystals with characteristic birefringence upon polarization.
Discussion: Gout commonly presents with erythema and swelling of acutely involved joints. Skin deposits of monosodium urate in the hands and feet typically overlie chronically involved joints. Subcutaneous deposition of urate away from joints, like our current lesion, is very rare and had been termed Gouty panniculitis. A relation to a preexisting damage to subcutaneous tissue (e.g. trauma or prior pancreatitis) has been suggested in some cases.
Reference(s):
– A Dahiya et al. Gouty panniculitis is a healthy male. J Am Acad Dermatol 2007: S52.Incorrect
Answer: Tophaceous gout
Histology: Amorphus eosinophilic material is seen deposited in the deep reticular dermis and subcutis. Surrounding giant cell foreign body reaction with mild lymphoplasmacytic infiltrate is present. The deposits are composed of needle shaped crystals with characteristic birefringence upon polarization.
Discussion: Gout commonly presents with erythema and swelling of acutely involved joints. Skin deposits of monosodium urate in the hands and feet typically overlie chronically involved joints. Subcutaneous deposition of urate away from joints, like our current lesion, is very rare and had been termed Gouty panniculitis. A relation to a preexisting damage to subcutaneous tissue (e.g. trauma or prior pancreatitis) has been suggested in some cases.
Reference(s):
– A Dahiya et al. Gouty panniculitis is a healthy male. J Am Acad Dermatol 2007: S52.
