The Freckled Girl
|A 6 y.o. girl is brought to your office for evaluation of "skin tags". She was the product of a normal delivery and had normal developmental milestones. In the last year she has begun to develop numerous subcutaneous nodules which are soft and freely mobile. Some of the nodules have been superficial enough to form "skin tags" and have become embarrassing for the young patient.|
Her physical and neurological examinations are normal except for the skin tags and a number of cafë-au-lait spots with a "Coast of California" border. She also has prominent freckles in non-sun-exposed areas such as her axilla. Her father accompanies her to the office and, on questioning, reports that he also has cafë-au-lait spots.