Tophaceous gout occurs when the amount of serum uric acid in the bloodstream increases and monosodium urate (MSU) crystals start to form. These crystals then grow into tophi and appear to the unaided eye as chalky lumps. Appearance of these crystals in the ears is common. Oftentimes, gout attacks make themselves apparent through crystal formation in the big toe. However, the levels of uric acid can remain high for many years before the symptoms of tophaceous gout are seen. The majority of gout sufferers will experience gout-related joint pain and inflammation between ten and twenty years following the initial rise in uric acid levels.
Tophi can develop from its original location, thus resulting in joint and bone damage. Alternatively, they can develop in new locations within the body, such as in cartilage, soft tissues and tendons. Tophi may grow into the bones of the body as well as on top of them. Tophi are responsible for the unsightly skin deformities which result from gout attacks. Tophi are more likely to occur in the extremities of the body, such as the hands and the feet. These areas are cooler than the rest of the body due to their distance from the heart.
The aim of tophaceous gout treatment is to reduce uric acid levels to 6 mg/dL. At this level, uric acid crystals should begin to dissolve. Drugs used in tophaceous gout treatment include allopurinol, uricosuric and febuxosat drugs. Tophaceous gout is common in the elderly as some elderly individuals are unable to take drugs of this kind. Anyone taking over-the-counter medicines, prescription-only medicines and herbal medicines should consult with their general physician before considering medical tophaceous gout treatment. They should also be screened for medical conditions that can cause high uric acid levels. Certain medical tophaceous gout treatments may not be suitable for use by pregnant or breastfeeding women.
If tophaceous gout treatment is not taken during a gout flare-up, chronic tophaceous gout will result. This condition can destroy the joints and bones, leading to reduced mobility of the joints in question. Joints can become ulcerated and septic as a result of uric acid crystal formation. This can be serious. Severe uric acid crystal formation can result in the joint exuding pus. Eventually, the crystal mass will burst out of the skin. In the event that tophaceous gout treatment fails to work, surgery may be required. Surgery aims to remove tophi that cause severe problems.
Tophaceous gout treatment does not typically involve changing an individual’s diet. This is because severe gout is unlikely to be effectively treated in this way. Some changes to the diet may aid an individual in coping with tophaceous gout. A diet low is purines may help to reduce high uric acid levels to some degree. Purines are found in oily fish and offal, to name just a few foods. It is recommended that individuals with gout consume eight to ten glasses of water per day to help to dilute uric acid. Individuals on medical tophaceous gout treatment should avoid consumption of grapefruit and grapefruit juice.