The shagreen patch. There is usually one lesion, but several may be present. They are soft, flesh-colored to yellow plaques with an irregular surface that has been likened to pig skin.

Hypomelanotic macules (oval or ash leaf shaped) are randomly distributed, with a concentration on the arms, legs, and trunk.

Periungual fibromas are conical, pink, firm projections from posterior nail folds of the fingers and toes. They appear around the time of puberty and persist indefinitely.