ISSN: 2161-1017
Kalpalata Tripathy, Aparajita Mishra, Debiprasad Mishra, Smrutirekha Behera and Lity Mohanty
Subcutaneous bullae over the finger can prove to be a challenge to diagnosticians and clinicians as it can mimic several other joint-related lesions. Gouty tophus and its diagnosis can be difficult in cases of atypical presentations. This report describes a case of chronic gout presenting as subcutaneous bullae only over palmer surface of hand, including the cytologic and histologic findings. A 41-year-old male presenting with multiple subcutaneous bullous lesions of 1 year duration came to the cytology out patient department for a Tzanck preparation. Aspiration yielded chalky white material. FNA smears revealed abundant granular amorphous material, and slender needle-like crystals with a granulomatous inflammatory reaction. Histopathologic confirmation was done and serum uric acid level was 16mg/dl. Fine needle aspiration cytology (FNAC) is a valuable diagnostic tool for the diagnosis of gouty tophi, even in cases of unusual presentation and the pathologist should be aware of the cytological features.