Search

Although gout is a common intermittent crystalline arthropathy, tophaceous gout is a rare condition. Flares of this disease are usually treated with anti-inflammatory drugs followed by control of serum uric acid levels. We present a refractory, severe, tophaceous gout overlapping with psoriatic arthritis, presenting with a hyper-inflamed phenotype resistant to conventional anti-inflammatory and hypouricemic agents. Control of the disease was only achieved after the introduction of IL-1-blocking therapy. This case highlights the need to control inflammation as the first step in gout treatment and underscores the increasing need for personalized therapies in more complex patients., Competing Interests: Human subjects: Consent for treatment and open access publication was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Coelho et al.)