Chronic tophaceous gout with severely deforming arthritis: a case report with emphasis on histopathologic considerations.

Abstract

The dramatic clinical presentation of a patient with severe deforming arthritis secondary to chronic tophaceous gout is described. Polarization microscopic examination and use of the De Galantha stain identified the dermal amorphous material as urate crystals. When the possibility of gout is entertained and a lesional biopsy specimen is examined to confirm the diagnosis, it is useful to fix the fresh tissue in absolute ethanol and process the specimen using an anhydrous technique to preserve the crystals.