Alopecia totalis (AT) is a chronic disease that results in non-scarring hair loss of the entire scalp. This results from an autoimmune reaction involving the hair follicles due to genetic and environmental factors. The clinical course of AT is highly unpredictable. There are limited effective durable treatment options. Resolution of alopecia has been reported post-autologous and allogenic hematopoietic stem cell transplantation (HSCT). However, no cases of AT remission following chemotherapy alone have been described. Here, we present a case of complete remission of AT following chemotherapy for B-cell acute lymphoblastic leukemia (B-ALL) in a pediatric patient.

Treatment of pediatric oncology patients generally results in significant immunosuppression and when the COVID-19 pandemic arose, there was concern among pediatric oncologists about the implications of this virus. We reviewed the literature and describe all pediatric oncology patients with COVID-19 reported worldwide. Within this review, it is striking that CNS tumors are reported at low numbers (27/466 pediatric oncology patients with COVID-19). This may be related to decreased inpatient care when compared to other pediatric cancers. Additional work is needed to understand the risk of infection in this population and gain insight into the effect on delivery of oncology care.