A 36-year-old woman with mild mental retardation and facial angiofibromas presented for evaluation of recurrent seizures, which she reported having had since childhood. Periungual fibromas were seen in the feet. These lesions, usually seen in adults, are typical of tuberous sclerosis, which this patient had. In adolescents, facial angiofibromas are often mistaken for acne when in fact these lesions may be indicative of a different condition. The patient was referred to a dermatologist for possible laser therapy but declined the referral. source: nejm.org