Gout panniculitis M10.00

Very rare form (in international literature there are <20 publications; Gaviria JL et al. 2015) of a lobar panniculitis caused by deposits of uric acid crystals in fatty tissue.

Mostly solitary or multiple painful, abscess-like, reddened plaques or nodules occurring on the lower extremity. These can ulcerate. In ulceration, white-yellow crumbly material is discharged from a fluctuating, abscess-like but non-purulent centre. Pattanaprichakul P et al. (2014) described a disseminated form with multiple, partially ulcerated plaques and nodules that occurred on both the extremities and the trunk, Medina YF et al. (2012) described a tumorous formation of gouty arthritis.

Severe lobular panniculitis with extensive necroses and massive foreign body reaction around needle-shaped tissue clefts. Occasionally, larger, sea-like accumulations of amorphous material are also described (Pattanaprichakul P et al. 2014).

Treatment of the underlying disease. Local anti-inflammatory measures.

Gaviria JL et al (2015) Unusual Dermatological Manifestations of Gout: Review of Literature and a Case Report. Plast Reconstr Surg Glob Open 3:e445

Maldonado Cid P et al (2017) High-frequency ultrasound features in a case of gouty panniculitis. Dermatol Online J 23. pii: 13030/qt33j2z14m.

Martin D et al (2017) An unusual location of gouty panniculitis: A case report. Medicine (Baltimore) 96:e6733.
Medina YF et al. (2012) Massive gouty pseudotumor. J Clin Rheumatol 18:451.

Pattanaprichakul P et al. (2014) Disseminated gouty panniculitis: an unusual presentation of extensive cutaneous tophi.Dermatol Pract Concept 4:33-35.