ASH LEAF SPOT of TUBEROUS SCLEROSIS
By Gary M. White, MD
The ash leaf spot is a hypopigmented patch that is usually the first manifestation of tuberous sclerosis (TS).
- In the majority they are present at birth, but may occur by one or two months of age.
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.).
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].
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