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Major features of TSC include cutaneous lesions such as adenoma sebaceum, more than three hypomelanotic macules, shagreen patch, and periungual fibromas; cortical tubers, subependymal nodules, retinal hamartomas, heart rhabdomyomas, renal angiomyolipomas, and lung lymphangiomyomatosis.
Dermatologically, patients may display hypopigmentation, cafe au lait macules, periungual fibromas, and adenoma sebaceum.
So-called shagreen patches develop at about the same time of onset of adenoma sebaceum in 15% to 20% of afflicted individuals.
On examination, child had Adenoma Sebaceum, Ash leaf macule (Fig.
Adenoma sebaceum was the commonest (95%) cutaneous feature of tuberous sclerosis followed by ash leaf macule and shagreen patch each seen in 90% patients followed by Koenen's tumour seen in 75% patients.
2) Sherlock (3) coined the name 'epiloia', the diagnostic triad composed of epilepsy, low intelligence and adenoma sebaceum.
In addition to this, adenoma sebaceum, hypomelanoticpatches("ash leaf spots") and shagreen patches [Fig.
Clinical diagnosis is easy when the patient presents with classical triad of seizures, mental retardation and adenoma sebaceum.