Numerous CALMs in a child with NF1.
Axillary freckling in child with NF1.
CALMs are tan oval macules with distinct borders. Multiple CALMs are an early sign of neurofibromatosis type 1 (NF1). CALMs are rarely present at birth but increase in number with age. One-fourth of healthy teens have at least one CALM, and having two is also common.