Ulcerated gouty tophus. Gouty tophus on the third toe of an 82-year-old man foot. Gout is an excess of uric acid accumulating in the blood and joints. The uric acid collects as crystals around the affected joint in a swelling known as a tophus. The affected toe is inflamed, swollen and very painful. Treatment involves the use of anti- inflammatory drugs to control the pain and inflammation. If attacks of gout are frequent, drugs can be given that either inhibit uric acid production or increase its excretion by the kidneys.
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