ASH LEAF SPOT of TUBEROUS SCLEROSIS
The ash leaf spot is a hypopigmented patch that is usually the first manifestation of tuberous sclerosis.
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).
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.
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