Congratulations to the winner of our September quiz, Vijay Zawar, MD, DNB, DVD, Skin Diseases Center, Nashik, India. The correct answer to our September challenge was trichodysplasia spinulosa. For a complete discussion of this case, see the Off-Center Fold section in the October Archives (Burns A, Arnason T, Fraser R, Murray S, Walsh N. Keratotic “spiny ” papules in an immunosuppressed child. Arch Dermatol. 2011;147:1215-1220).