This 15-year old boy presented to my office with multiple asymptomatic papules on the face since age of three.
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Note the firm papulonodular lesions with a friable vascular surface distributed on the nose and right nasolabial fold. These lesions, called adenoma sebaceum, are actually angiofibromas - a form of cutaneous hamartoma. The patient has no neurological deficit, but tuberous sclerosis can affect many organ systems: heart, brain, kidney, liver and eyes. The lesions can be removed by light cautery and curettage or carbon dioxide laser therapy. The latter is more expensive and not much better.
A good review can be found on emedicine.com
Submitted by Henry Foong, Ipoh, Malaysia. Contact Dr. Foong.
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