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app for risk assessment of pigmented and non-pigmented skin lesions-a study on sensitivity and specificity in detecting malignancy. Telemed J E Health 2017; 23: 948-954. 7 SkinVision. [WWW document]. URL https://www.skinvision.com/news/ skinvision-to-join-nhs-innovation-accelerator (last accessed: 26 May 2020). 8 Freeman K, Dinnes J, Chuchu N et al. Algorithm based smartphone apps to assess risk of skin cancer in adults: systematic review of diagnostic accuracy studies. BMJ 2020; 368: m127.

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We report a case of a 3-year-old girl with a 9-month history of focal neurologic finding and signs of increased intracranial pressure. Radiological imaging studies showed a minimally heterogeneous enhancing large tumor involving left parietal region and partly filling the left lateral ventricle. Microscopically, the tumor contained prominent small true rosettes set into areas of fibrillar neuropil-like matrix. Foci of cellular tumor with extensive apoptosis were present. The neuropil-like areas and true rosettes were positive for synaptophysin immunostain. The tumor was negative for GFAP and neurofilament protein immunostains. MIB-1 proliferation index was high focally approaching 80%.

A 69-year-old woman with a history notable for lichen planus, breast cancer status post chemotherapy 7 years previously, and fibroid-related menorrhagia status post hysterectomy and bilateral oophorectomy 20 years previously presented with a 6-year history of facial hyperpigmentation and new painful, nonpruritic, blisters, erosions, and scabbing lesions on the backs of both of her hands. She had been taking ferrous sulfate 325 mg 3 times daily since her menorrhagia diagnosis 25 years previously. Exam revealed diffuse hyperpigmented patches on the face with hypertrichosis of the temporal region (Fig 1) and fragile skin with crusted papules on the dorsal aspect of both hands (Fig 2).