FINGERTIP TOPHI WITHOUT GOUTY-ARTHRITIS

We report 2 patients without a history of acute gouty arthritis showin g tophi located only on the fingertips, an unusual location. A review of the literature found a few similar reports; these patients might re present a subgroup of gout characterized by: (1) elderly patients, fro m the 7th to 9th decades; (2) hyperuricemia; (3) absence of a history of acute gouty arthritis; (4) tophi in the fingertips or fingerpads; ( 5) chronic renal failure, and (6) all taking drugs or suffering from a disease that affects urate renal excretion.