Multiple Noduloulcerative Lesions over Extremities: Can Cytology be Diagnostic?

DOI: 10.4103/ijd.IJD_460_16 A 51-year-old man presented with numerous mobile, skin-colored, tender, subcutaneous nodules over the extensor aspects of his superior and inferior extremities for the past 2 years. These nodules measured between 1 and 5 cm in diameter. Some of the right pretibial lesions were ulcerated and oozed chalky substances. The associated small joints of hands and feet were disfigured [Figure 1]. Their mobility was partially compromised. However, the skin overlying these distorted peripheral joints lacked any inflammatory changes. On further interrogation, he also recalled few episodes of asymmetric arthritis involving hands and feet during the past 15 years. Family history of gout as well as personal history of diabetes, hypertension, alcoholism, purine-rich diet, and exposure to chemicals/heavy metals was negative.