First-line Treatment for Wound Healing of Tophi Ulceration in a Patient with Gout and Type 2 Diabetes: A Case Report

Abstract

Background: Tophi ulceration with infection and refractory wound healing remains a clinical challenge, particularly in patients with concurrent diabetes. Interleukin-1β (IL-1β) is a central mediator of gouty inflammation; targeted IL-1 inhibition may rapidly suppress inflammation and facilitate tissue repair. Case Presentation: This study reported the case of a 27-year-old male with a 6-year history of gouty arthritis, multiple tophi, infected left foot ulceration, and type 2 diabetes. Despite conventional anti-infective therapy, glycemic control, and local wound care, the ulcer showed limited improvement. Following a single subcutaneous injection of firsekibart (200 mg), wound exudate decreased rapidly, granulation tissue developed satisfactorily, and the ulcer healed progressively. At the 4-month follow-up, complete wound closure was achieved without recurrence or adverse events. Conclusion: Firsekibart demonstrated favorable anti-inflammatory and wound-healing effects in a patient with tophi ulceration complicated by diabetes, suggesting its potential as a therapeutic option for refractory cases. Prospective studies are warranted to confirm these findings.