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Dermatology

Neurofibromatosis and Tuberous Sclerosis Complex

Built from Dermatology, 5th Edition

The first 25 slides of Neurofibromatosis and Tuberous Sclerosis Complex
The first 25 slides, exactly as they appear. The full deck has 165 content slides.

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6 sections · 165 slides

  1. 01

    Neurocutaneous Disorders: Overview

    Phakomatoses, autosomal dominant inheritance, and the dermatologist's role in diagnosis

    • What is a phakomatosis?
    • Classifying neurofibromatosis

    2 slides

  2. 02

    Neurofibromatosis Type 1

    Also called von Recklinghausen disease

    • Neurofibromatosis type 1: key features
    • History of neurofibromatosis type 1
    • Epidemiology of neurofibromatosis type 1
    • The NF1 gene and neurofibromin
    • Genotype-phenotype patterns in NF1
    • The tumor microenvironment and neurofibroma formation
    • Mechanism: how neurofibromin loss drives growth
    • Clinical features of NF1: overview
    • Major clinical features of neurofibromatosis type 1
    • Major clinical features of neurofibromatosis type 1 (continued)
    • Major clinical features of neurofibromatosis type 1 (continued)
    • Major clinical features of neurofibromatosis type 1 (continued)
    • Major clinical features of neurofibromatosis type 1 (continued)
    • Cafe-au-lait macules
    • Cafe-au-lait macules and freckling
    • Neurofibromas: the tumor that names the disease
    • Multiple cutaneous neurofibromas
    • Less common cutaneous neurofibroma patterns
    • Neurofibroma subtypes at a glance
    • Subcutaneous neurofibromas
    • Plexiform neurofibromas
    • Natural history of plexiform neurofibromas
    • Malignant transformation of plexiform neurofibromas
    • Juvenile xanthogranuloma and leukemia risk
    • Vascular findings: nevus anemicus and glomus tumors
    • Lisch nodules of the iris
    • Choroidal abnormalities
    • Mosaic (segmental) neurofibromatosis type 1
    • Optic pathway gliomas
    • Other CNS tumors and brain MRI findings
    • Learning, behavior, and seizures
    • Skeletal manifestations of NF1
    • Cardiovascular manifestations of NF1
    • Timeline of clinical features developing in NF1
    • Why the order of findings matters
    • Pathology of NF1 skin lesions
    • Pathology of malignant peripheral nerve sheath tumor
    • Diagnosing NF1: classic and revised criteria
    • Revised diagnostic criteria for NF1 and mosaic NF1
    • Revised diagnostic criteria for NF1 and mosaic NF1 (continued)
    • Approach to a child with 6 or more cafe-au-lait macules
    • How reliable are cafe-au-lait macules alone?
    • Molecular testing for NF1
    • Segmental look-alikes of mosaic NF1
    • Legius syndrome
    • Other entities in the differential diagnosis
    • Disorders associated with multiple cafe-au-lait macules
    • Disorders associated with multiple cafe-au-lait macules (continued)
    • Disorders associated with multiple cafe-au-lait macules (continued)
    • Disorders associated with multiple cafe-au-lait macules (continued)
    • Disorders associated with multiple cafe-au-lait macules (continued)
    • Disorders associated with multiple cafe-au-lait macules (continued)
    • Disorders associated with multiple cafe-au-lait macules (continued)
    • Disorders associated with multiple cafe-au-lait macules (continued)
    • Disorders associated with multiple cafe-au-lait macules (continued)
    • Neurofibromatosis type 2: how it differs from NF1
    • Key features of neurofibromatosis type 2
    • McCune-Albright syndrome
    • Plexiform neurofibroma vs congenital melanocytic nevus
    • Managing NF1: the general approach
    • Evaluation and management of patients with NF1
    • Evaluation and management of patients with NF1 (continued)
    • Treating the skin lesions of NF1
    • Watching for malignant transformation
    • Targeted drug therapy for NF1 tumors
    • NF1 patient resources
    • 02b
    • Axillary lentigines and cafe-au-lait macule
    • Multiple lentigines, cafe-au-lait macules, and neurofibromas
    • Large cafe-au-lait macule with neurofibromas and Crowe sign
    • Multiple neurofibromas with lentigines
    • Neurofibromas of the areola
    • Plexiform neurofibromas: sagging bag-like plaques
    • Plexiform neurofibroma with 'bag of worms' texture
    • Plexiform neurofibroma misdiagnosed as a birthmark
    • Plexiform neurofibroma presenting as a hyperpigmented plaque
    • Plexiform neurofibroma in a child

    77 slides

  3. 03

    Tuberous Sclerosis Complex

    Also known as Bourneville-Pringle disease or 'epiloia'

    • Tuberous sclerosis complex: key features
    • The two TSC genes
    • History of tuberous sclerosis complex
    • Epidemiology of tuberous sclerosis complex
    • The TSC genes and their protein products
    • Mechanism: how TSC gene loss drives hamartomas
    • Which gene, which severity?
    • Clinical features of TSC: overview
    • Major clinical features of tuberous sclerosis complex
    • Major clinical features of tuberous sclerosis complex (continued)
    • Hypomelanotic macules
    • Confetti (guttate) macules
    • Cafe-au-lait macules in TSC
    • Facial angiofibromas
    • Fibrous cephalic plaque
    • Shagreen patch (collagenoma)
    • Ungual fibromas
    • Molluscum pendulum and oral findings
    • Retinal hamartomas
    • Order in which cutaneous features of TSC appear
    • Infantile spasms
    • Intellectual and behavioral effects (TAND)
    • Subependymal nodules and SEGA
    • Cortical dysplasia and tubers
    • Cardiovascular manifestations of TSC
    • Renal manifestations of TSC
    • Pulmonary and other manifestations
    • Where each TSC organ system is affected
    • Pathology of TSC skin lesions
    • Pathology of the shagreen patch
    • Diagnosing tuberous sclerosis complex
    • Diagnostic criteria for tuberous sclerosis complex
    • Approach to an infant with 3 or more hypomelanotic macules
    • Genetic testing yield in TSC
    • Other syndromes that mimic TSC skin findings
    • Hypopigmented and shagreen-patch look-alikes
    • Managing tuberous sclerosis complex
    • Evaluation and management of tuberous sclerosis patients
    • Evaluation and management of tuberous sclerosis patients (continued)
    • mTOR inhibitors: a shared systemic therapy
    • Sun protection and topical therapy for angiofibromas
    • Evidence for topical sirolimus
    • TSC patient resources
    • 03b
    • Ash leaf macules
    • Confetti and polygonal hypomelanotic macules
    • Facial angiofibromas and fibrous plaque
    • Facial angiofibromas in an adult
    • Fibrous plaque of the forehead
    • Large fibrous cephalic plaque
    • Shagreen patch with an ash leaf macule
    • Shagreen patch
    • Collagenoma with a leather-like surface
    • Multiple ungual fibromas
    • Longitudinal red streaks ('red comets')
    • Ungual fibromas of the toes
    • Shagreen patch histology stains
    • Calcified subependymal nodules on cranial CT

    58 slides

  4. 04

    Riccardi's Historical Classification

    How the seven original NF subtypes map onto today's understanding

    • Why Riccardi's scheme still matters
    • Riccardi's classification of neurofibromatosis

    2 slides

  5. 05

    Summary

    NF1 and TSC side by side

    • NF1 vs TSC: cutaneous hallmark features
    • NF1 vs TSC: shared disease logic
    • Key takeaways

    3 slides

  6. 06

    References

    Source citations from this chapter

    • References
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    • References (continued 22)
    • Dermatology, 5th Edition (2-Volume Set)

    23 slides