ASH LEAF SPOT of TUBEROUS SCLEROSIS

By Gary M. White, MD

Ash leaf macule of Tuberous Sclerosis


The ash leaf spot is a hypopigmented patch that is usually the first manifestation of tuberous sclerosis (TS).

Clinical

The ash leaf macule appears as a hypopigmented (but not depigmented) spot congenitally or in a young child. In order to make the diagnosis, look for other signs of tuberous sclerosis in the child or family (1/3 of cases of TS are familial.).

Differential Diagnosis

See here

Treatment

Topical rapamycin 0.2% gel BID (powder from a 2 mg rapamycin tablet mixed with 100 mg gel) for 12 weeks improved the hypopigmented macules in 6 patients with TS [JAMA Derm 2015;151;722].

Additional Pictures

Ash leaf macule of Tuberous Sclerosis Ash leaf macule of Tuberous Sclerosis Ash leaf macule of Tuberous Sclerosis Ash leaf macule of Tuberous Sclerosis Ash leaf macule of Tuberous Sclerosis

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