12 yrs old female patient complaints of this type of lesions since 6 months..no h/o itching.tell me the diagnosis and treatment please....

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Clinical examination in case of facial Angiofibromas Some form of dermatological sign is present in 96% of individuals with TSC. Most cause no problems, but are helpful in diagnosis. Some cases may cause disfigurement, necessitating treatment. The most common skin abnormalities include: 1)Facial angiofibromas ("adenoma sebaceum"): A rash of reddish spots or bumps, which appears on the nose and cheeks in a butterfly distribution, they consist of blood vessels and fibrous tissue. This potentially socially embarrassing rash starts to appear during childhood and can be removed using dermabrasion or laser treatment. 2 Periungual fibromas: Also known as Koenen's tumors, these are small fleshy tumors that grow around and under the toenails or fingernails and may need to be surgically removed if they enlarge or cause bleeding. These are very rare in childhood, but common by middle age. They are generally more common on toes than on fingers, develop at 15–29 years, and are more common in women than in men. They can be induced by nail-bed trauma. 3 Hypomelanic macules ("ash leaf spots"): White or lighter patches of skin, these may appear anywhere on the body and are caused by a lack of melanin. They are usually the only visible sign of TSC at birth. In fair-skinned individuals, a Wood's lamp(ultraviolet light) may be required to see them. 4 Shagreen patches: Areas of thick leathery skin that are dimpled like an orange peel, and pigmented, they are usually found on the lower back or nape of the neck, or scattered across the trunk or thighs. The frequency of these lesions rises with age. .The child must be evaluated for any learning difficulities. About 50% of people with TSC have learning difficulties ranging from mild to significant and studies have reported that between 25% and 61% of affected individuals meet the diagnostic criteria for autism. Neurological symptoms are seizures, intellectual disability, developmental delay, and behavioral problems. Symptoms also include trouble in school and concentration problems. The child may need brain study be X-ray, MRI (personally I do not like CAT scan- child get lot of radiation).) Multiple systems are affected like CNS, kidney, lungs, Heart, eyes, pancreas ect. Variability:Individuals with TSC may experience none or all of the clinical signs discussed above. TSC is a genetic disorder with an autosomal dominant pattern of inheritance, variable expressivity, and incomplete penetrance. Two-thirds of TSC cases result from sporadic genetic mutations, not inheritance, but their offspring may inherit it from them. Hence there is vast variability of clinical presentation. Follow the patient. The child may not get any systemic involvement. Most of tumors are Hamartoms (bening growths) and very rarely, cancerous hamartoblastomas Thanking you.

A case of tuberous sclerosis showing facial Angiofibromas in characteristic butterfly pattern. Tuberous sclerosis, also known as tuberous sclerosis complex, is a rare genetic condition that causes mainly non-cancerous (benign ) tumours to develop in different parts of the body. The tumours most often affect the brain, skin, kidneys, heart, eyes and lungs. (Acne vulgaris will show polymorphous rash, i.e. comedones, papules, pustules etc.)

Angiofibromas. (TUBEROUS SCLEROSIS) . Look for 1. Low intelligence. Other signs 1. Subungual fibroma 2. SHAGREEN PATCH . H/O Epilepsy. @Dr. Upender Singh

Tuberous sclerosis showing facial angiofibroma Agree with dr pankaj sir Request to dr pankaj sir illustration on treatment and further investigation of the same

acne vulgaris

Sir treatment please
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Tuberous sclerosis

TUBEROUS SCLEROSIS SHOWING ANGIOFIBROMAS

Looks like Adenoma sebaceum. Adv CT brain to exclude Tuberous sclerosis.

@Dr. Upender Singh -angiofibroma

Tuberous sclerosis

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