TUBEROUS SCLEROSIS
ENTER
GREET THE EXAMINERS
SANITISE YOUR HANDS
INTRODUCE YOURSELF TO THE PATIENT

Hands: periungual fibroma
Arms: AV fistula, BP
Neck: scars from dialysis
Face: papular salmon-coloured eruption in butterfly pattern
over the cheeks/chin/forehead especially in the nasolabial
folds (adenoma sebaceum: facial angiofibroma’s)
Mouth: intraoral fibroma, hypertrophic gums
(phenytoin/ciclosporin use), dentition
Chest and back: leathery thickened skin-coloured
patches/plaques on the lower back (Shagreen’s patches),
hypopigmented macules in oval/ash leaf configuration on
trunk and buttocks (ask to look with Woods lamp as the
depigmented macule will fluoresce), café au lait macules
CVS: (CCF from cardiac rhabdomyomata), Resp
(pneumothorax, corpulmonale, cystic lung disease), Abdo
(polycystic kidneys angiomyolipomas, peritoneal dialysis,
transplant kidney, nephrectomy)
Eyes – fundoscopy for retinal hamartomata which are
yellow/grey/white (phakomata)