What are the clinical manifestations of tophite?

Tophite is caused by the accumulation of sodium glutamate and urate under the skin. Tophite is clinically manifested as articular cartilage, helix, tendon sheath, toe, subcutaneous tissue and other related symptoms. Tophite is more common in the present helix, perhaps related to blood acid at the helix. Or it is the first metatarsophalangeal joint, finger, wrist and knee joint of the present toe. Tophites can also invade bone near joints, deforming or damaging bone. Tophites vary in size and shape, some as small as sesame seeds. Tophites thin the skin or form fistulas that are difficult to heal.