Digital dermatoscopy is used to capture accurately the time-dependent growth of dermal neurofibromas and cafe-au-lait macules and patches on the skin of NF1 patients. Sequential images of lesions on patients and associated biopsies have been performed on pediatric and adult patients. In 2008, the addition of pediatric patients to this project was accomplished. As the study progesses, we anticipate obtaining quantitative information about the rate of lesion development and change in both the pediatric and adult NF1 population. Additionally, we anticipate beginning a study of the rate of change in response to therapy of facial papules on patients with Cowden's syndrome.