Nayereh Saadati - Ghaem Medical Center, Mashhad University of Medical Sciences, Mashhad, Iran
Bahram Naghibzadeh - Rheumatic Diseases Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
Zeinab Saremi - Ghaem Medical Center, Mashhad University of Medical Sciences, Mashhad, Iran

Hyperuricemia is reported to have a high prevalence in patients with psoriasis. This metabolic derangement can be associated with the development of gout in such patients. Presented herein is the case of a 53-year-old male who referred to the hospital because of worsening of skin lesions and multiple swollen and painful joints. Physical examination showed symmetric involvement of the patient’s knee, first metatarsophalangeal, and subtalar joints. Knee fluid aspiration revealed numerous monosodium urate monohydrate (MSUM) crystals. The patient’s serum uric acid level was 10 mg/dL. Kidney function was normal. Although he had experienced a similar episode two years earlier with involvement of the first metatarsophalangeal joint, he did not seek medical attention then and was not receiving prophylaxis for gout. Treatment with prednisone, allopurinol, colchicine, and sulfasalazine resulted in improvement of the symptoms. The patient was followed for six months and no relapse in his skin conditions or gouty attacks were observed. It is prudent to measure uric acid levels in psoriatic patients. Psoriatic patients with hyperuricemia, even without a known cause for hyperuricemia, are at increased risk of developing gouty arthritis. This presentation suggests that psoriasis can be an independent risk factor for gouty attacks, though this requires further larger studies.

gout, hyperuricemia, Psoriasis