Tuberous sclerosis complex (TSC) is characterized by abnormalities of the skin, brain, kidney, heart, and lungs. Skin findings are present in nearly all patients with TSC, and major criteria in skin include facial angiofibromas, forehead plaque, nontraumatic ungual or periungual fibromas, three or more hypomelanotic macules, or a shagreen patch. Major features involving other body systems include multiple retinal nodular hamartomas, cortical tuber, subependymal nodule, subependymal giant cell astrocytoma, cardiac rhabdomyoma, lymphangiomyomatosis, and renal angiomyolipoma. Minor features include randomly distributed pits in dental enamel, hamartomatous rectal polyps, bone cysts, cerebral white matter radial migration lines, gingival fibromas, non-renal hamartoma, retinal achromic patch, confetti skin lesions, and multiple renal cysts. Individuals who meet diagnostic criteria for definite TSC have two major features or one major and two minor features, probable TSC requires one major plus one minor feature, and possible TSC is one major or two or more minor features (Roach and Sparagano 2004).