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To the Editor.—
While collections of irritating, autologous, serum uric acid in unusual locations have been reported before, a case of symptomatic gouty tophus of the nose has not been annotated previously to our knowledge.
Report of a Case.—
A 66-year-old man has been in good health all of his life except for hyperlipoproteinemia and gout. Having known that he had gouty arthritis, he has been receiving probenecid since it was first released for medical use. His practitioner attempted to convert his therapy to allopurinol, but it stirred up his gout so much that the patient refused ever to try the medication again.Gradually over a three-year period the patient noticed that the bridge of his nose had become enlarged and that his eyeglasses no longer fit, causing diplopia (Fig 1). Because of this problem and its interference with the patient's driving, the tophus was removed surgically (Fig 2). Roentgenograms
Rask MR, Kopf EH. Nasal Gouty Tophus. JAMA. 1978;240(7):636. doi:10.1001/jama.1978.03290070038006