Alopecia in children undergoing chemotherapy, radiation, and hematopoietic stem cell transplantation: Scoping review and approach to management.

Alopecia is a common sequela in children undergoing chemotherapy, radiation, and hematopoietic stem cell transplantation. In most cases, this is a transient state in which full hair regrowth eventually occurs, but permanent or persistent alopecia, defined as the presence of incomplete hair regrowth more than 6 months after cessation of treatment, is possible and can be psychologically distressing. We sought to characterize the risk factors that can lead to permanent alopecia following the aforementioned treatments in pediatric populations, as well as diagnostic and treatment options that may be considered, as part of a scoping review of the literature. A general algorithm for approaching these patients was developed based on our findings.

Mammary Paget disease in Darier disease: beware the wolf in sheep's clothing.

This case describes new onset mammary Paget disease arising in the background of Darier disease. Clinically and histologically, lesions of Darier disease can mask the lesions of mammary Paget disease. A high index of suspicion is necessary to diagnose Paget disease in a patient with Darier disease, for a potentially fatal disease could easily be missed.

Simultaneous lichen striatus in siblings along the same Blaschko line.

Lichen striatus (LS) is an asymptomatic, spontaneously resolving linear dermatosis consisting of 2 to 4 mm flat topped papules following the lines of Blaschko. Two siblings presented with a simultaneous occurrence of LS along the same Blaschko line of the left upper extremity. Only four other cases of a simultaneous occurrence of LS in related siblings have been reported, but none of these have occurred in the same extremity. Although 10 years have passed since the last case report of this unique concurrent familial eruption, few discoveries have been made regarding its etiology. Several theories have been proposed including environmental agents, cutaneous injury, viral infection, hypersensitivity, and genetic predisposition. These theories are discussed along with retrotransposons, a possible new explanation for the pathogenesis of this and other Blaschko line disorders.

Reflectance confocal microscopy: an overview of technology and advances in telepathology.

The value of in vivo reflectance confocal microscopy (RCM) as a noninvasive adjunctive tool in dermatology has steadily advanced since its inception. With RCM, dermatologists can view horizontal sections of lesions in a resolution comparable to histology, observe dynamic processes in living skin, and monitor lesion evolution longitudinally. This article will compare RCM to dermoscopy and histology, review the general principles of the microscope, describe the findings seen on confocal images, and discuss the clinical applications of this noninvasive tool. Additionally, we describe a telepathology network dedicated to the transfer of confocal images to remote dermatopathologists for interpretation. Finally, we will discuss the adoption of RCM and the telepathology network in clinical practice.