This is a symptom of gout

The correct option is "All of the above".

Gout is a painful form of inflammatory arthritis caused by the accumulation of uric acid crystals in the joints. An attack of gout typically presents with several distinct stages and symptoms, which include all of the individual options listed:
1. Severe pain, warmth and swelling in joints: This is the hallmark symptom of an acute gout attack. Uric acid crystals trigger a strong inflammatory response, causing intense pain (often starting suddenly at night), noticeable swelling, and the joint feeling hot to the touch.
2. Purple or red skin: Due to the intense inflammation and increased blood flow to the affected area, the skin over and surrounding the joint typically becomes highly congested, turning red or purplish, and appearing shiny.
3. Itching skin, peeling at the site of gout attack: As the acute attack subsides and the swelling goes down, the skin that was stretched during the peak of the inflammation begins to heal. This healing process commonly causes the skin to itch, flake, and peel.

Since all these symptoms are characteristic features of gout, the correct choice is indeed "All of the above".