HISTOPATHOLOGICAL STUDY OF CUTANEOUS LESIONS IN GOUT

Abstract

Aim: To document the spectrum of histological changes of cutaneous lesions found in patients with gout. Material and methods: Thirteen cutaneous biopsies were studied. The biopsies were fixed in formalin solution and stained with hematoxyline and eosin. Results: A common feature in all 13 cases was the presence of deposits of basophilic material with needle-like clefts. The main histological reaction pattern was palisading granuloma. In 7 cases the deposits were subcutaneously located and in 6 cases intradermal and subcutaneously. The inflammatory infiltrate contained mainly epithelioid histiocytes and multinucleate giant cells. In 5 cases it also contained neutrophils and in one case foam cells. Secondary changes were found in 6 cases. Conclusion: When the clinical findings are atypical, cutaneous biopsy remains an important tool to establish the diagnosis of tophi, even in those cases with no possibility to exam alcohol fixed specimens under polarized light. In our study the preliminary clinical diagnosis was consistent with the histological findings in only 3 cases. The key feature that allowed the correct diagnosis was the presence of basophilic material with needle-like clefts surrounded by a palisading histiocytic infiltrate.