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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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How Can Gout On The Big Toe Be Treated?

I have gout in my right big toe and has been very sensitive and swollen for ten plus days. The longest bout I ever had. After work I took off my socks and noticed a white blister about the size of the end of my pinky. Larger than a end of an eraser on a pencil. I lanced it with just the tip of my pocket knife and sqeezed out a lot of puss until no more but blood came out. I'm soaking it in epsum salt right now. How did this happen? I always wear foot protection so it was not an puncture from the outside in. Did the infection start from the inside out? Will my toe need to be removed?
Tue, 7 Nov 2017
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Ayurveda Specialist,  's  Response
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Thanks for contacting with your health concern

1. As you have not mentioned the value of serum uric acid, so it could be a gout attack [due to building up of uric acid in the joints], gouty arthritis [ inflammation in the joints [most often in the big toe] causing swelling, pain, redness, stiffness in the joint.

PS. The white blister could be 'tophi' [ complication with gout] and by squeezing it with a knife you have posed a serious problem of infection, so seek an emergency treatment and consult a Rheumatologist.

2. Since these tophi [if comes out to be after examination] are more of an annoyance and doctors rarely turns to surgery, since initially, one can go with uric acid-lowering diet and lifestyle modifications to see whether they can be shrunk and late turn to surgical procedure [for cosmetic reasons]
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How Can Gout On The Big Toe Be Treated?

** Thanks for contacting with your health concern 1. As you have not mentioned the value of serum uric acid, so it could be a gout attack [due to building up of uric acid in the joints], gouty arthritis [ inflammation in the joints [most often in the big toe] causing swelling, pain, redness, stiffness in the joint. PS. The white blister could be tophi [ complication with gout] and by squeezing it with a knife you have posed a serious problem of infection, so seek an emergency treatment and consult a Rheumatologist. 2. Since these tophi [if comes out to be after examination] are more of an annoyance and doctors rarely turns to surgery, since initially, one can go with uric acid-lowering diet and lifestyle modifications to see whether they can be shrunk and late turn to surgical procedure [for cosmetic reasons]