History:

 Asymptomatic, erythematous to skin-colored multiple papules, most of which are discrete but few are coalesced togther forming plaques. Many skin tags were seen on both sides of the neck. Facial papular lesions (adenoma sebaceum) invovlved the face diffusely, however they were more concentrated at nasolabial folds. The lesions have been noticed since age of 5 years. The patient is on oral anticonvalscent therapy for few years. These lesions have been treated with fractional ablative CO2 laser with marked improvement of facial appearance.

N.B.

1. Ash-leaf hypopigmented macule was seen since birth.

2. Strangely, this case has been misdiagnosed as inflammatory acne !!!

This case is presented by Dr. Ayman Abdelmaksoud, MD, Egypt.