Gout. Close-up of the ear of a patient suffering from gout, showing tophi (white swellings) in the earlobe and around the pinna of the ear. Gout is a disease caused by a defect in uric acid metabolism. Excessive uric acid (and its salts, sodium urate) accumulate in the bloodstream and the joint capsules forming tophi. These are an acute inflammation, with accompanying swelling, redness & pain. Gout has traditionally been associated with excessive living", in particular overeating and overdrinking. Treatment involves the use of anti-inflammatory drugs and abstention from rich foods & excessive alcohol."