Cutaneous manifestations of TSC

The prominence of FAFs (Fig. 1, Supplementary Fig. 1), HMs (Supplementary Fig. 2), connective tissue nevi (SHP; Supplementary Fig. 3)—so termed because they are elevated, contrasting patches that reflect only color changes; hence the term “shagreen patch” should be avoided and replaced by the correct terminology “plaque”—FCPs (Supplementary Fig. 4), and UFs (Supplementary Fig. 5) underscores their importance as diagnostic hallmarks.5 FCPs and FEP (Supplementary Fig. 6)—clinically similar to skin tags, while larger, more numerous, and with an earlier onset—were especially common, contrasting earlier reports suggesting lower prevalence.5 Similarly, OFs (Supplementary Fig. 7) and DEPs, although often under-recognized, were frequently detected under examination, emphasizing the need for multidisciplinary evaluation.