ASH LEAVE MACULES

Diagnosis: ASH LEAVE MACULES

Case submitted by Dr.Azeem Alam Khan to the dermRounds community.

Clinical Presentation

Clinical photograph(s) submitted for peer review and discussion.

Clinical History

Submitted by Dr.Azeem Alam Khan. Originally posted October 7, 2010.

Treatment

See case discussion.

Differential Diagnosis

• Vitiligo • Pityriasis alba • Nevus depigmentosus • Piebaldism • Post-inflammatory hypopigmentation • Tinea versicolor

Key Learnings

• Hypopigmented macules shaped like an ash tree leaf — one of earliest signs of tuberous sclerosis • Present in >90% of tuberous sclerosis patients • Best visualized with Wood lamp examination, especially in fair-skinned individuals • One of the major diagnostic criteria for tuberous sclerosis complex • May be present at birth or early infancy • Three or more ash leaf macules in an infant should prompt TSC workup

Tags: ash, leave, macules, dr.azeem alam khan