Tophaceous lesion of the middle third of the nose.

A69-year-old male with a history of gouty arthropathy, came under our observation with a subcutaneous tophaceous nodule of the medial third of the dorsal portion of the nose (Figure 1), which had appeared 3 years earlier and grew slowly. The nodule, firm and painless, was resected following a perilesional plane of cleavage down to the deep margin of the lesion, which involved the joint between the triangular cartilage and the septum superiorly, and between the septum and the posterior side of the medial crura inferiorly. Given the rarity of presentation of such gouty conditions in the soft tissues of the face1,2 and, to our knowledge, the case reported here is the first to occur in the joints between the cartilages of the nose, tophaceous lesions can hardly be included in the differential diagnosis of swellings of the nasal pyramid. Moreover, tophaceous lesions located on the face do not seem to coincide with a more aggressive picture of the disease.