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Andrew Lane, MD, PhD, explains that blastic plasmacytoid dendritic cell neoplasm (BPDCN) is a rare blood cancer that usually presents with red to purple skin lesions and requires an expert hematopathologist to diagnose using specific immunohistochemistry markers. He notes that central nervous system involvement is more common than previously thought, so all BPDCN patients should get lumbar punctures and intrathecal chemotherapy. The treatment goal is remission followed by allogeneic stem cell transplant for possible long-term remission or cure, as no therapies alone have proven sufficient. The only FDA-approved drug is tagraxofusp, though intensive ALL-like chemotherapy remains standard.