What is an ash leaf Macule?

What is an ash leaf Macule?

Hypopigmented macules, also known as “ash-leaf spots,” can be present at birth and are most common on the trunk and lower extremities. They appear in 80 percent of persons with tuberous sclerosis by one year of age. Thus, they are the earliest indicator of this disorder.

What do ash-leaf spots look like?

These present as hypopigmented off-white coloured macules 1–3 cm in size, predominantly over trunk and buttocks. Their shape may vary, classical lesions are ovoid or leaf shaped hence their name.

What causes an ash leaf spot?

Fungal leaf spots on ash may be caused by two different fungi: Mycosphaerella effigurata and M. fraxinicola. The diseases associated with these fungi are sometimes called Mycosphaerella leaf spot. Other names used in the past include “Piggotia leaf spot,” and “Phyllosticta leaf spot.”

What are Hypomelanotic Macules?

Hypomelanotic macules, or hypopigmented macules, are not lesions, but simply patches of skin lighter than the surrounding area. They vary in size from several millimeters to several centimeters in diameter. They also vary in shape but are generally elliptical or lance shaped (commonly called “ash leaf” shaped).

Can ash leaf spots be normal?

Solitary ash leaf macules are common in normal newborns. However, more than one lesion at birth should prompt evaluation for tuberous sclerosis, as up to 90% of patients with tuberous sclerosis will show multiple ash leaf macules at birth. Capillary malformations are very common, occurring in 40% of infants.

Can ash leaf spots disappear?

Sometimes hypomelanotic macules become less obvious in adulthood, and may even disappear. Hypomelanotic macules are usually the size of a thumbprint or larger. They are also referred to as ash-leaf spots when they are oval at one end and pointed at the other, resembling the leaf of the European mountain ash tree.

What is Hypopigmented mycosis fungoides?

Hypopigmented mycosis fungoides (HMF) is a form of cutaneous T-cell lymphoma (CTCL), a heterogeneous group of extranodal non-Hodgkin’s lymphomas.

What is a Angiofibroma?

A benign (not cancer) tumor that is made up of blood vessels and fibrous (connective) tissue. Angiofibromas usually appear as small, red bumps on the face, especially on the nose and cheeks. They are common in patients with tuberous sclerosis (a genetic disorder that causes skin lesions, seizures, and mental problems).

What is Periungual fibroma?

Periungual fibromas are rare benign dermatologic lesions that may be acquired or associated with tuberous sclerosis or von Recklinghausen’s disease. Periungual fibromas may place excessive pressure on the nail matrix, resulting in the potential for extensive nail pathologic conditions and pain.

What are hypopigmented macules (ash leaf spots)?

Hypopigmented macules, also known as “ash-leaf spots,” can be present at birth and are most common on the trunk and lower extremities. They appear in 80 percent of persons with tuberous sclerosis by one year of age.

What are ash-leaf spots or naevus depigmentosus?

Ash-leaf spots or naevus depigmentosus: a diagnostic challenge. Abstract. Ash-leaf spots, a diagnostic manifestation of tuberous sclerosis complex, are sometimes difficult to differentiate from other hypopigmented lesions.

What are the differential diagnoses of hypopigmented macules?

Important differential diagnoses of hypopigmented macules include naevus depigmentosus (ND), naevus anaemicus, ash-leaf spots and vitiligo. As clinical differentiation between ash-leaf spots and ND is not always possible, other features of tuberous sclerosis complex (TSC) should be searched to help in making the final diagnosis.

Is naevus depigmentosus the same as vitiligo?

Vitiligo, naevus anaemicus and naevus depigmentosus are important clinical differentials for ash-leaf spots. Among these naevus depigmentosus poses maximum difficulty because of clinical as well as histological similarities. Here we describe a 6-month-old child with multiple segmental hypopigmented macules over the face.