• David Martin, Gaëtan-Romain Joliat, Pierre Fournier, Christophe Brunel, Nicolas Demartines, and Olivier Gié.
• aDepartment of Visceral Surgery bInstitute of Pathology, University Hospital CHUV, Lausanne, Switzerland.
• Medicine (Baltimore). 2017 Apr 1; 96 (16): e6733.

RationaleGouty panniculitis, characterised by the deposition of monosodium urate crystals in subcutaneous tissue, is a rare clinical manifestation of gout.Patient ConcernsThe case of a 67-year-old man is reported, who presented an erythematous nodule on the upper part of the right buttock suspicious for an abscess. This was in the context of chemotherapy for non-Hodgkin's lymphoma.DiagnosesHistopathologic examination demonstrated gouty panniculitis.InterventionsBecause infection was suspected, an incision was performed. The lesion was found to be densely calcified and friable, without purulent discharge. Therefore, a surgical en-bloc resection was performed.OutcomesThe wound healed slowly initially due to a combination of malnutrition, chemotherapy and infection. A wound infection with Enterococcus faecium was treated with antibiotic therapy (carbapenem for seven days) and local therapy. At 6-week follow up the wound showed good granulation tissue and was healing well by secondary intention. The patient was instructed to continue anti-hyperuricaemic treatment.Lessons SubsectionsIn patients known to have long-standing hyperuricaemia and gout with nonspecific subcutaneous erythematous nodules, gouty panniculitis should be considered.

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