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Erythema elevatum diutinum presenting as multiple nodules of the hands mimicking gouty tophi
Corresponding author: Dr. Shuaihantian Luo, Department of Dermatology, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China. lsht5309@csu.edu.cn
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Received: ,
Accepted: ,
How to cite this article: Yiu N, Zhang G, Luo S. Erythema elevatum diutinum presenting as multiple nodules of the hands mimicking gouty tophi. Indian J Dermatol Venereol Leprol. 2026;92:411. doi: 10.25259/IJDVL_544_2025
A 65-year-old man presented with an 11-year history of multiple nodules on his hands. Physical examination showed multiple firm discrete, and coalescing nodules and plaques on both palms and fingers with irregular margins mimicking gouty tophi [Figure 1]. An X-ray of the hands demonstrated no specific deformities. Skin biopsy revealed dense neutrophilic infiltration in the dermis and focal collagen sclerosis. Residual foci of leukocytoclastic vasculitis were present in the upper and mid-dermis. No uric acid crystals were observed. Based on the clinical and histological findings, a diagnosis of erythema elevatum diutinum (EED) was made. Intralesional injections of betamethasone (7mg/ml):1ml per injection once a month for three months were effective during the 1-year follow-up.
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Conflicts of interest
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