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Apibal Y et al. - The authors present a case of a 70-year-old female who abruptly developed deep-seated pustule at both palms and soles. Aspiration content of the papule for gram’s stain revealed needle-shaped materials with negative birefringence polarized light examination. Histological examination revealed deposition of amorphous materials surrounded by histiocytes, multinucleated giant cells, and lymphocytes in the dermis, which is a characteristic of gouty tophi.

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