Hand findings in an elderly lady

77y, white woman, nursing home resident, PMH of HTN, DM, CHF, A fib and DJD, was hospitalized earlier this month for anorexia, diarrhea and weakness for the past several months. She is being treated with Lasix, Prevacid, Toprol, Oxycodone, Coumadin, L-thyroxine, Spironolactone, Glipizide, Effexor, Colchicine and Probenecid. On exam, she is dehydrated corroborated by a BP of 90/40 and pulse rate of 80 - 100/m. The following findings are noted on her hands.
What is the most likely diagnosis?

1. Heberden’s and Bouchard’s nodes
2. Rheumatoid nodulosis with possible “geodes”
3. A description by Dr. Thomas Syndenham in the 17th century- ANSWER (tophaceous gout).
4. Calcinosis cutis

Journalist with a rash

62 y, white man, editor of a local newspaper, with PMH of HTN and Hyperlipidemia, presents today complaining of recurrent, non-pruritic rash over his flanks, back and groin. He reports that the rash tends to recur in summer months and also after his exercise routine, if he does not get to the shower in a few hours. He denies any exposure to new chemicals, topical or systemic. He also denies any systemic symptoms.
On exam, he has sharply marginated, brownish-red slightly scaling macular eruption involving his back, flanks and intertriginous skin.
Which of the following organisms is the most likely culprit?

1. Malassezia
2. Candida species
3. Corynebacterium minutissimum- correct answer
4. S. Aureus
5. Human Herpes Virus 7