Tophaceous Lesion of Nose with Silicone Prosthesis Implantation-Case Report

Abstract

Background: Deposition of monosodium urate crystals in joint and soft tissue finally forms tophi in chronic gout cases. The tophaceous deposits were most commonly found around the fingers or the big toe, however in unsual cases, they could be found over other sites, such as the ears, spinal cord, pancreas, thyroid cartilage, tongue, eyes, breast and nose Aim and Objectives: We present a case with tophi formation surrounding her nasal silicone prosthesis, and this is the first case as known to the present literatures. Materials and Methods: A 54-year-old woman who had received nasal silicone implant for augmentation more than 10 years ago, came with the chief complaint of painful hump over the middle third of the nasal ridge for 6 months. Infection of prosthesis was impressed. The prosthesis was removed, and the mass of nasal hump was then removed through curettage and dissection. Cannelures were found over the silicone prosthesis. Result: Histopathologic examination revealed deposits of amorphous material, and typical birefringence of urate crystal was shown. Post operative colchicine and allopurinol were prescribed. At the last follow, which was 1 year post operation, neither wound infection nor recurrence of tophi was found. Conclusion: Implantation of prosthesis for cosmetic reason became more and more popular in modern society. As the lifestyle changes, more and more patients would confront with hyperuricemia and its series of chronic symptoms. Plastic surgeons should always take hyperuricemia into consideration, as nasal prosthesis may be a risk factor for tophi deposition.