SAT0425 CLINICAL CHARACTERISTICS AND RISK FACTORS OF ULCERATION OVER TOPHI IN PATIENTS WITH GOUT. (June 2019)

• Record Type: Journal Article
• Authors: Huang, Zhengping; Liu, Xiuqi; Liu, Yuqi; Tianwang, LI
• Is Part Of: Annals of the rheumatic diseases. Volume 78(2019)Supplement 2
• Page Start: 1301
• Page End: 1302
• Publication Date: 2019-06
• Subjects: Rheumatism -- Periodicals; 616.723005
• DOI: 10.1136/annrheumdis-2019-eular.2607
• Languages: English
• ISSNs: 0003-4967

Abstract

Abstract : Background: With increasing prevalence of gout world-wide, ulceration associated with tophaceous gout is becoming increasingly common in recent years. Investigation of the clinical characteristics and risk factors will allow us to better understand the fact of ulceration over tophi and improve the management for such challenge problem. Objectives: To describe clinical characteristics of ulceration over tophi in patients with gout and determine risk factors associated with ulceration. Methods: Patients presenting with tophi or ulceration(s) over tophi were prospectively recruited and their clinical characteristics were recorded. Comparison of clinical characteristics and risk factors for ulceration were analyzed between groups. Results: A total of 105 patients were enrolled. 33 patients with ulcerations were older, with prolonged duration with gout and tophi, a higher rate of obesity, greater number of tophi, lower level of GFR, and higher level of serum creatinine, ESR and CRP. The mean duration of ulceration was 1.63 ± 2.32 months. The ulcerations mainly located in ankle (34.21%) and MTP (39.47%), with a mean size of 32.37 × 22.76 mm. The majority of ulcerations were categorized as stage I (42.4%) and stage II (51.5%). In univariate regression analysis, age, glucocorticoid abuse, gout duration, tophi duration, tophi number and GFR were associated with ulceration. In the multivariable model, significant differences were demonstrated in glucocorticoid abuse, tophi duration, tophi number. Conclusion: Gout patients with ulceration(s) over tophi present several different aspects of clinical characteristics compared with those without ulceration. Glucocorticoid abuse, prolonged duration with tophi and greater number of tophi are risk factors for ulceration over tophi. Avoiding indiscriminate use of glucocorticoid needs to be emphasized, and prevention of tophi formation via initiate effective urate-lowering therapy is highly recommended in patients with gout. References: [1] Lam G, Ross FL, Chiu ES. Nonhealing Ulcers in Patients with Tophaceous Gout: A Systematic Review. Adv Skin Wound Care. May2017;30(5):230-237. Disclosure of Interests: None declared