The ulceration associated with gout tophi is very difficult to treat because of impaired and halted local inflammatory response resulting from the gout treatment regimen. We report chronic nonhealing tophaceous gout with bursitis in an 80-year-old male, not responding to conventional treatment modality for months together. This nonhealing ulcer was treated successfully with local application of 3% citric acid ointment for 22 days.
RussellRCGWilliamsNSBulstrodeCJK. Bailey & Love’s Short Practice of Surgery. 25th ed.London, England: Edward Arnold; 2008:441.
2.
MandelDASimkinPA. Gout: update on pathogenesis, diagnosis, and treatment. New Dev Rheum Dis. 2007;20-25. www.medpub.com/NDRDv4n3_Simkin.pdf. Accessed July 15, 2013.
3.
KasperDLFauciASLongoDLBraunwaldEHauserSLJamesonJL. Harrison’s Principles of Internal Medicine. 16th ed.New York, NY: McGraw-Hill; 2005:2046.
4.
LeeSSSunIFLuYMChangKPLaiCSLinSD. Surgical treatment of the chronic tophaceous deformity in upper extremities—the shaving technique. J Plast Reconstr Aesthet Surg. 2009;62:669-674.
5.
PatelGKDaviesWLPricePPHardingKG. Ulcerated tophaceous gout. Int Wound J. 2010;7:423-427.
6.
SchlesingerNDalbethNPerez-RuizF. Gout—what are the treatment options?Expert Opin Pharmacother. 2009;10:1319-1328.
7.
BassiJLMahindraPSinghJ. Bilateral upper and lower limb ulcers due to gout—a case report. Indian J Orthop. 2008;40:53-54.
NagobaBSPunpaleASAyachitRGandhiRCWadherBJ. Citric acid treatment of postoperative wound in an operated case of synovial sarcoma of the knee. Int Wound J. 2011;8:425-427.
10.
NagobaBSGandhiRCWadherBJRaoAHartalkarARSelkarSP. A simple and effective approach for the treatment of diabetic foot ulcers with different Wagner grades. Int Wound J. 2010;7:153-158.
11.
NagobaBSWadherBJRaoASelkarSPGandhiRC. Treatment of lepromatous ulcers using citric acid as a sole antimicrobial agent. Int Wound J. 2012;9:553-556.
12.
NagobaBSGandhiRCHartalkarARWadherBJSelkarSP. Simple, effective and affordable approach for the treatment of burns infections. Burns. 2010;36:1242-1247.
13.
HartalkarARNagobaBS. Tuberculous inguinal lymphadenitis with multiple discharging sinuses—an unusual presentation. Indian J Surg. 2013;75:149-150.
14.
NagobaBSGandhiRCWadherBJPotekarRMKolheSM. Microbiological, histopathological and clinical changes in chronic wounds after citric acid treatment. J Med Microbiol. 2008;57:681-682.