Gota y sus manifestaciones dermatológicas
Palabras clave:
gota, artritis gotosa, cristales de urato monosódico, tofosResumen
La gota es la artritis más común en hombres entre los 40 y los 60 años de edad. Es causada por el depósito de cristales de urato monosódico en las articulaciones y en otros tejidos luego de un tiempo prolongado de hiperuricemia. Afecta al 1% de la población estadounidense adulta y su prevalencia se viene aumentando por el incremento en la longevidad y por el uso de diuréticos y ácido acetilsalicílico. La gota es considerada como una de las manifestaciones del síndrome metabólico. Por lo tanto, no es raro encontrar algunas manifestaciones cutáneas durante el curso de la enfermedad.
Biografía del autor/a
Juan Pablo Restrepo
Médico internista, reumatólogo; profesor, Universidad del Quindío, Armenia, Colombia
Joaquin Berrío
Médico dermatólogo; profesor, Universidad del Quindío, Armenia, Colombia
Referencias bibliográficas
1. Pande I. Update on gout. Indian J Rheumatol. 2006;1:60-5.
2. McCarty D, Hollander J. Identification of urate crystals in gouty synovial fluid. Ann Intern Med. 1961;54:452-60.
3. Arromdee E, Michet C, Crowson C, O’Fallon W, Gabriel S. Epidemiology of gout: Is the incidence rising? J Rheumatol. 2002;29:2403-6.
4. Richette P, Bardin T. Gout. Lancet. 2010;375:318-28.
5. Restrepo JP, Pascual E. Gota en el anciano. Rev Colomb Reumatol. 2008;15:12-9.
6. Eggebeen A. Gout: An update. Ann Fam Phys. 2007;76:801-8.
7. Petrilli V, Martinon F. The inflasommasome, autoinflammatory diseases and gout. Joint Bone Spine. 2007;74:571-6.
8. Martinon F, Petrilli V, Mayor A, Tardivel A, Tschopp J. Gout associated uric acid crystals activate the NALP3 inflammasome. Nature. 2006;440:237-41.
9. Harris M, Siegel L, Alloway J. Gout and hyperuricemia. Ann Fam Phys. 1999;59:925-34.
10. McCarty D. Gout without hyperuricemia. JAMA. 1994;271:302-3.
11. Urano W, Yamanaka H, Tsutani H, Nakajima H, Matsuda Y, Taniguchi A. The inflammatory process in the mechanism of decreased serum uric acid concentrations during acute gouty arthritis. J Rheumatol. 2002;29:1950-3.
12. Macfarlane D, Dieppe P. Diuretic-induced gout in elderly women. Br J Rheumatol. 1985;24:155-7.
13. Lally E, Zimmermann B, Ho G Jr, Kaplan S. Urate-mediated inflammation in nodal osteoarthritis: Clinical and roentgenographic correlations. Arthritis Rheum. 1989;32:86-90.
14. Holland N, Jost D, Beutler A, Schumacher H, Agudelo C. Finger pad tophi in gout. J Rheumatol. 1996;23:690-2. 15. Fam A, Assaad D. Intradermal urate tophi. J Rheumatol. 1997;24:1126- 31.
16. Snider A, Barsky S. Gouty panniculitis: A case report and review of the literature. Cutis. 2005;76:54-6.
17. Lillcrap M. Gout. Clin Med. 2007;1:60-4.
18. Suresh E. Diagnosis and management of gout: a rational approach. . Postgrad Med J. 2005;81:572-9.
19. Gout histopathology. Lever´s histopathology of the skin, Ninth edition. Philadelphia: PA: Lippincott Williams and Wilkins, 2005. p. 447-448.
20. Emmerson B. The management of gout. N Engl J Med. 1996;334:445-51.
21. Maccagno A, Di Giorgio E, Romanowicz A. Effectiveness of etodolac (Lodine®) compared with naproxen in patients with acute gout. Curr Med Res Opin. 1991;12:423-9.
22. Schumacher H Jr, Boice J, Daikh D, Mukhopadhyay S, Malmstrom K, Ng J, et al. Randomized double blind trial of etoricoxib and indometacin in treatment of acute gouty arthritis. BMJ. 2002;324:1488-92.
23. Cheng TT, Lai HM, Chiu CK, Chem Y. A single-blind, randomized, controlled trial to assess the efficacy and tolerability of rofecoxib, diclofenac sodium and meloxicam in patients with acute gouty arthritis. Clin Ther. 2004;26:399-406.
24. Spilberg I, Mandell B, Mehta J, Simchowitz L, Rosenberg D. Mechanism of action of colchicine in acute urate crystalinduced arthritis. J Clin Invest. 1979;64:775-80.
25. McInnes G, Lawson D, Jick H. Acute adverse reactions attributed to allopurinol in hospitalized patients. Ann Rheum Dis. 1981;40:245-9.
26. Hande K, Noone R, Stone W. Severe allopurinol toxicity: Description and guidelines for prevention in patients with renal insufficiency. Am J Med. 1984;76:47-56.
27. Teng G, Nair R, Saag K. Pathophysiology, clinical presentation and treatment of gout. Drugs. 2006;66:1547-63.
28. Schlesinger N, Dalbeth N, Pérez-Ruiz F. Gout: What are the treatment options? Expert Opin Pharmacother. 2009;10:1319-26.
29. Ernst M, Fravel M. Febuxostat: A selective xanthine-oxidase/ xantine-dehydrogenase inhibitor for the management of hyperuricemia in adults with gout. Clin Ther. 2009;31:2503-18.
30. Mayer M, Khosravan R, Vernillet I, Wu J, Joseph-Ridge N, Mulford D. Pharmacokinetics and pharmodynamics of febuxostat, a new non-purine selective inhibitor of xantine oxidase in subjects with renal impairment. Am J Ther. 2005;12:22-34.
31. Ali S, Lally E. Treatment failure of gout. Med Health RI. 2009;92:369-71.
32. Goldman S. Rasburicase: Potential role in managing tumor lysis in patients with hematological malignancies. Expert Rev Anticancer Ther. 2003;3:429-33.
33. Yim B, Sims-McCallum R, Chong P. Rasburicase for the treatment and prevention of hyperuricemia. Ann Pharmacother. 2003;37:1047-54.
34. Bomalaski J, Holtsberg F, Ensor C, Clark M. Uricase formulated with polyethylene glycol (uricase-PEG 20): Biochemical rationale and preclinical studies. J Rheumatol. 2002;29:1942-9.
35. Nishimura H, Matsushima A, Inada Y. Improved modification of yeast uricase with polyethylene glycol (uricase-PEG 20): Biochemical rationale and preclinical studies. J Rheumatol. 2002;29:1942-9.
36. Sundy J, Becker M, Baraf H, Barkhuizen A, Moreland L, Huang W et al. Reduction of plasma urate levels following treatment with multiple doses of pegloticase (polyethyleneglycol-conjugated uricase) in patients with treatment-failure gout. Arthritis Rheum. 2008;58:2882-91.
37. Pope R, Tschopp J. The role of interleukin-1 and the inflammasome in gout. Implications for therapy. Arthritis Rheum. 2007;56:3183-88.
38. Terkeltaub R, Zachariae C, Santoro D, Martin J, Pevere P, Matsushima K. Monocyte-derived neutrophil chemotactic factor/interleuquin-8 is a potential mediator of crystalinduced inflammation. Arthritis Rheum. 1991;34:894-903.
39. Martinon F, Glimcher L. Gout: New insights into an old disease. J Clin Invest. 2006;116:2073-5.
40. So A, De Smedt T, Revaz S, Tschopp J. A pilot study of IL-1 inhibition by anakinra in acute gout. Arthritis Res Ther. 2007;9:R28.
41. Sunny J. Progress in the pharmacotherapy of gout. Curr Opin Rheumatol. 2010;22:189-93.
42. Lui T. Endoscopic resection of the gouty tophi of the first metatarsophalangeal joint. Arch Orthop Trauma Surg. 2008;128:521-3.
43. Lee S. Surgical treatment of the chronic tophaceous deformity in upper extremities - the shaving technique. J Plast Reconstr Aesthet Surg. 2009;62:669-74.
2. McCarty D, Hollander J. Identification of urate crystals in gouty synovial fluid. Ann Intern Med. 1961;54:452-60.
3. Arromdee E, Michet C, Crowson C, O’Fallon W, Gabriel S. Epidemiology of gout: Is the incidence rising? J Rheumatol. 2002;29:2403-6.
4. Richette P, Bardin T. Gout. Lancet. 2010;375:318-28.
5. Restrepo JP, Pascual E. Gota en el anciano. Rev Colomb Reumatol. 2008;15:12-9.
6. Eggebeen A. Gout: An update. Ann Fam Phys. 2007;76:801-8.
7. Petrilli V, Martinon F. The inflasommasome, autoinflammatory diseases and gout. Joint Bone Spine. 2007;74:571-6.
8. Martinon F, Petrilli V, Mayor A, Tardivel A, Tschopp J. Gout associated uric acid crystals activate the NALP3 inflammasome. Nature. 2006;440:237-41.
9. Harris M, Siegel L, Alloway J. Gout and hyperuricemia. Ann Fam Phys. 1999;59:925-34.
10. McCarty D. Gout without hyperuricemia. JAMA. 1994;271:302-3.
11. Urano W, Yamanaka H, Tsutani H, Nakajima H, Matsuda Y, Taniguchi A. The inflammatory process in the mechanism of decreased serum uric acid concentrations during acute gouty arthritis. J Rheumatol. 2002;29:1950-3.
12. Macfarlane D, Dieppe P. Diuretic-induced gout in elderly women. Br J Rheumatol. 1985;24:155-7.
13. Lally E, Zimmermann B, Ho G Jr, Kaplan S. Urate-mediated inflammation in nodal osteoarthritis: Clinical and roentgenographic correlations. Arthritis Rheum. 1989;32:86-90.
14. Holland N, Jost D, Beutler A, Schumacher H, Agudelo C. Finger pad tophi in gout. J Rheumatol. 1996;23:690-2. 15. Fam A, Assaad D. Intradermal urate tophi. J Rheumatol. 1997;24:1126- 31.
16. Snider A, Barsky S. Gouty panniculitis: A case report and review of the literature. Cutis. 2005;76:54-6.
17. Lillcrap M. Gout. Clin Med. 2007;1:60-4.
18. Suresh E. Diagnosis and management of gout: a rational approach. . Postgrad Med J. 2005;81:572-9.
19. Gout histopathology. Lever´s histopathology of the skin, Ninth edition. Philadelphia: PA: Lippincott Williams and Wilkins, 2005. p. 447-448.
20. Emmerson B. The management of gout. N Engl J Med. 1996;334:445-51.
21. Maccagno A, Di Giorgio E, Romanowicz A. Effectiveness of etodolac (Lodine®) compared with naproxen in patients with acute gout. Curr Med Res Opin. 1991;12:423-9.
22. Schumacher H Jr, Boice J, Daikh D, Mukhopadhyay S, Malmstrom K, Ng J, et al. Randomized double blind trial of etoricoxib and indometacin in treatment of acute gouty arthritis. BMJ. 2002;324:1488-92.
23. Cheng TT, Lai HM, Chiu CK, Chem Y. A single-blind, randomized, controlled trial to assess the efficacy and tolerability of rofecoxib, diclofenac sodium and meloxicam in patients with acute gouty arthritis. Clin Ther. 2004;26:399-406.
24. Spilberg I, Mandell B, Mehta J, Simchowitz L, Rosenberg D. Mechanism of action of colchicine in acute urate crystalinduced arthritis. J Clin Invest. 1979;64:775-80.
25. McInnes G, Lawson D, Jick H. Acute adverse reactions attributed to allopurinol in hospitalized patients. Ann Rheum Dis. 1981;40:245-9.
26. Hande K, Noone R, Stone W. Severe allopurinol toxicity: Description and guidelines for prevention in patients with renal insufficiency. Am J Med. 1984;76:47-56.
27. Teng G, Nair R, Saag K. Pathophysiology, clinical presentation and treatment of gout. Drugs. 2006;66:1547-63.
28. Schlesinger N, Dalbeth N, Pérez-Ruiz F. Gout: What are the treatment options? Expert Opin Pharmacother. 2009;10:1319-26.
29. Ernst M, Fravel M. Febuxostat: A selective xanthine-oxidase/ xantine-dehydrogenase inhibitor for the management of hyperuricemia in adults with gout. Clin Ther. 2009;31:2503-18.
30. Mayer M, Khosravan R, Vernillet I, Wu J, Joseph-Ridge N, Mulford D. Pharmacokinetics and pharmodynamics of febuxostat, a new non-purine selective inhibitor of xantine oxidase in subjects with renal impairment. Am J Ther. 2005;12:22-34.
31. Ali S, Lally E. Treatment failure of gout. Med Health RI. 2009;92:369-71.
32. Goldman S. Rasburicase: Potential role in managing tumor lysis in patients with hematological malignancies. Expert Rev Anticancer Ther. 2003;3:429-33.
33. Yim B, Sims-McCallum R, Chong P. Rasburicase for the treatment and prevention of hyperuricemia. Ann Pharmacother. 2003;37:1047-54.
34. Bomalaski J, Holtsberg F, Ensor C, Clark M. Uricase formulated with polyethylene glycol (uricase-PEG 20): Biochemical rationale and preclinical studies. J Rheumatol. 2002;29:1942-9.
35. Nishimura H, Matsushima A, Inada Y. Improved modification of yeast uricase with polyethylene glycol (uricase-PEG 20): Biochemical rationale and preclinical studies. J Rheumatol. 2002;29:1942-9.
36. Sundy J, Becker M, Baraf H, Barkhuizen A, Moreland L, Huang W et al. Reduction of plasma urate levels following treatment with multiple doses of pegloticase (polyethyleneglycol-conjugated uricase) in patients with treatment-failure gout. Arthritis Rheum. 2008;58:2882-91.
37. Pope R, Tschopp J. The role of interleukin-1 and the inflammasome in gout. Implications for therapy. Arthritis Rheum. 2007;56:3183-88.
38. Terkeltaub R, Zachariae C, Santoro D, Martin J, Pevere P, Matsushima K. Monocyte-derived neutrophil chemotactic factor/interleuquin-8 is a potential mediator of crystalinduced inflammation. Arthritis Rheum. 1991;34:894-903.
39. Martinon F, Glimcher L. Gout: New insights into an old disease. J Clin Invest. 2006;116:2073-5.
40. So A, De Smedt T, Revaz S, Tschopp J. A pilot study of IL-1 inhibition by anakinra in acute gout. Arthritis Res Ther. 2007;9:R28.
41. Sunny J. Progress in the pharmacotherapy of gout. Curr Opin Rheumatol. 2010;22:189-93.
42. Lui T. Endoscopic resection of the gouty tophi of the first metatarsophalangeal joint. Arch Orthop Trauma Surg. 2008;128:521-3.
43. Lee S. Surgical treatment of the chronic tophaceous deformity in upper extremities - the shaving technique. J Plast Reconstr Aesthet Surg. 2009;62:669-74.
Cómo citar
1.
Restrepo JP, Berrío J. Gota y sus manifestaciones dermatológicas. rev. asoc. colomb. dermatol. cir. dematol. [Internet]. 5 de marzo de 2019 [citado 25 de abril de 2024];19(3):231-6. Disponible en: https://revista.asocolderma.org.co/index.php/asocolderma/article/view/365
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2019-03-05
Cómo citar
1.
Restrepo JP, Berrío J. Gota y sus manifestaciones dermatológicas. rev. asoc. colomb. dermatol. cir. dematol. [Internet]. 5 de marzo de 2019 [citado 25 de abril de 2024];19(3):231-6. Disponible en: https://revista.asocolderma.org.co/index.php/asocolderma/article/view/365
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