A 30-year-old Mexican woman had rash, deep ulcerations of her lower extremities, and debilitating polyarthritis. Her disorder simulated rheumatoid vasculitis, but serum rheumatoid factor was absent. The diagnosis of gout was confirmed by uric acid crystals in joint fluid and skin biopsy specimens and by x-ray crystallography. The age and sex were unusual for a patient with gout, and she had none of the commonly associated metabolic defects. This unique presentation for urate arthropathy needs further study.