Chronic tophaceous gout is a manifestation of longstanding, untreated hyperuricemia, characterized by monosodium urate crystal deposition in soft tissues and joints. While commonly presenting as nodular or papular tophi, rare morphologic variants such as miliarial gout may occur. We present a case of a 35-year-old Filipino male who presented with classic cutaneous manifestations of chronic tophaceous alongside numerous widespread, milia-like papules containing chalky tophaceous material, consistent with miliarial gout. This distinct and uncommon variant has only been reported in a few cases worldwide. Notably, the patient had a history of prolonged unsupervised corticosteroid use, renal insufficiency, and poor compliance to urate-lowering therapy, all of which may have contributed to the rapid and extensive cutaneous involvement. This case highlights the importance of early recognition of atypical gout presentations and emphasizes the potential role of corticosteroids in modifying disease progression and morphology.

Human ; Male ; Adult: 25-44 Yrs Old

Background: Skin metastases are rare yet crucial indicators of advanced disease. They can mimic various skin conditions, making them challenging to diagnose. Aims and Objectives: To investigate the incidence rate of biopsy-confirmed cutaneous metastasis and explore the clinical presentation, workup, and diagnostic techniques for skin metastases Materials and Methods: Local study involving comprehensive laboratory tests, pathological examination, and immunohistochemistry to identify primary tumors and confirm diagnoses. Results: Nodules were the most common manifestation of skin metastases, particularly in breast carcinoma. The chest wall and abdomen were frequent sites of involvement. Pathological examination and immunohistochemistry played a critical role in confirming diagnoses, revealing various histopathologic patterns. Immunohistochemical markers assisted in determining tumor origin but required careful interpretation. Monitoring tumor behavior over time provided insights into nature and origins. Conclusion Comprehensive workups including laboratory testing, pathology, and immunohistochemistry are essential for accurate diagnosis and management of skin metastases. Careful monitoring of tumor behavior can provide valuable information about its nature and origins.
Diagnosis