In a young woman with facial flesh-colored papules in the nasolabial folds and MRI showing subependymal nodules, what is the most likely diagnosis?

• A. Tuberous sclerosis
• B. Neurofibromatosis
• C. Sturge-Weber
• D. Von Hippel-Lindau

Answer: (A)

Recognize tuberous sclerosis by combining skin and brain findings. The flesh-colored papules around the nasolabial folds are facial angiofibromas, a classic cutaneous sign of tuberous sclerosis. The MRI showing subependymal nodules along the ventricles is a hallmark CNS lesion in this condition. Together, these features point to tuberous sclerosis rather than other neurocutaneous syndromes. Neurofibromatosis would show neurofibromas and café-au-lait spots; Sturge-Weber presents with a facial port-wine stain and leptomeningeal angiomas; Von Hippel-Lindau involves retinal and CNS hemangioblastomas.