The patient has adenoma sebaceum (which is usually distributed
in a butterfly pattern over the central face) and
subungual fibroma. Other
lesions which may be present (usually on the trunk) are shagreen
patches (these are
localized thickening of the skin with a rough surface)
and ash-leaf patches (hypopigmented areas which are best
seen with Wood's light ie. ultraviolet light).
mention you like to examine the fundus for astrocytic
hamartoma (the patients may have profound mental
retardation making fundal examination difficult).