A 17 year old boy with tuberous sclerosis demonstrates many of the characteristic findings of the autosomal dominant genodermatosis. Image 1282 demonstrates angiofibromas scattered around a shagreen patch on his back. Image 1284 shows another shagreen patch on his abdomen, and image 1285 shows angiofibromas on his nose cheeks and chin as well as pustules from acne vulgaris on his chin. Angiofibromas, particularly on the cheeks and upper lip, should not be mistaken for comedones and may suggest the diagnosis of tuberous sclerosis even in an otherwise healthy child.
superficial hyperpigmented and hypopigmented firm round plaque (3 cm diameter) on the abdomen with multiple scattered hyperpigmented papules (2-3 mm)