Reflectance confocal microscopy is a reliable diagnostic technique for evaluation of skin photoaging with objective criteria. With the new emerging compact models it is possible to scan even the least accessible body parts with no discomfort to the patient, which offers the possibility to assess the effect of antiaging applications and to identify early signs of solar damage in cosmetically sensitive areas.

Reflectance confocal microscopy is a fast, direct and noninvasive method for Demodex-associated diseases and it is superior to SSSB for Demodex mite detection.

A 63-year-old immunocompetent patient presented with a 4 month history of 12 painless nodules in a linear array on his right arm. He had a history of a surgery for a cutaneous tumor on the dorsum of his right middle finger about a year prior, but he did not follow up after the surgery. A differential diagnosis of sporotrichosis, atypical mycobacteria, deep fungal infection, and metastatic cutaneous squamous cell carcinoma (SCC) was considered. Skin biopsy revealed islands of dysplastic squamous cells and keratin pearls in a desmoplastic stroma in the deep dermis and subcutaneous tissue. The behavior of the disease was very aggressive, with rapid dissemination in a linear array, mimicking an infectious sporotrichoid spread. To our knowledge, this is the second case report of sporotrichoid metastases to the skin from cutaneous SCC in an immunocompetent patient.

Erythema ab igne (EAI) is a dermatosis characterised by reticulate red-brown pigmentation and telengiectasia resulting from long-term exposure to infrared radiation. It generally occurs in individuals using heating devices in the winter, those who frequently use hot compresses, and those who prefer hot environments. It generally occurs on the feet of women but may also occur on the hips and thighs. A 42-year-old male presented with red-brown spots and blisters on both thighs and behind the legs. He was diagnosed with EAI based on the clinical, historical, and histopathological features presented. Herein we present a case of bullous EAI associated with normochromic normocytic anemia and subclinical hypothyroidism.

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