Congratulations to the winner of our August quiz, Prasad Chinaiah, MD, Vindhya Clinic and Diagnostic Laboratory, Karnataka, India. The correct answer to our August challenge was chronic tophaceous gout. For a complete discussion of this case, see the Off-Center Fold section in the September Archives (Lesesky EB, Pelle MT, O'Grady TC. Diffuse nodules in a woman with renal failure. Arch Dermatol. 2007;143:1201-1206).