I think this is the best tophi picture. Because it shows successful tophi treatment. Most tophi photographs are horrible. But I think you should know the dangers of untreated gout.
Despite the advances in science that mean we can now control gout, there is a tiny minority who cannot tolerate common uric acid-lowering treatment. If you do not get uric acid to safe concentration, you are doomed to the continuous growth of tophi. So, you might treat the pain, but can you control the gout?
Pain relief without uric acid control means more and more uric acid crystals that will eventually show themselves as gouty tophi.
Best Tophi Picture
I have shown many terrifying tophi pictures. Because I want you to realize that untreated gout is serious.
Gout treatment, however, has its limitations. What do you do if you are in that tiny minority who cannot tolerate mainstream uric acid lowering treatment?
The good news is: help is at hand.
Rather than trying to expel more uric acid with uricosurics like probenecid, or inhibit uric acid production with xanthine oxidase inhibitors like allopurinol or febuxostat (Uloric/Adenuric), why not simply convert uric acid to something less harmful?
During my years of gout, and my search for gout freedom, I have been fascinated by the development of what is now known as Krystexxa. The easiest way for you to track that development is to search for puricase, PEG-uricase, pegloticase, or Krystexxa, in the search box above. Because those are the labels for a remarkable gout medication during various stages of development.
Like any scientific research, the studies of the development of Krystexxa can be tedious at times. What makes it really interesting are these before and after photographs of tophi in a gout patient treated with pegloticase.
Here, we have a situation where uric acid has a difficult time. In other gout treatments, it is encouraged to leave the body, or discouraged from being produced. With Krystexxa, uric acid disappears. It is converted to other harmless compounds, so the treatment gives remarkably low levels of uric acid in the blood. At those levels, tophi cease to be a long-term threat. As the pictures show, they simply melt.
Other Tophi Treatments
It is good to see that a low level of uric acid will cause tophi to shrink. It may take longer with allopurinol or Uloric, but those gouty lumps will go. Just make sure you get your uric acid concentration low enough. The upper limit is 5mg/dL (0.30mmol/L), but going lower for a year or so will shrink those tophi faster.
If you don’t do this soon enough then your tophi treatment might be surgery. You can see details of surgery and other techniques for tophi removal in the treatment for gout guidelines.
Your Best Tophi Picture
Do you have a tophi picture to share? Please send me your tophi picture or any gout photograph.
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