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Multiple periungual fibromas are considered a major criterion for the diagnosis of tuberous sclerosis (TS). The significance of a single periungual fibroma is not clear. Investigators in France evaluated seven adults with solitary periungual fibromas, and compared their cases clinically and histologically with six cases of known TS and periungual fibromas. Patients underwent detailed personal and family histories, physical examinations with Wood's lamp, and CT and/or MRI of the head.
The solitary fibromas were clinically and histologically identical to those seen in TS. However, the TS patients had multiple fibromas in multiple sites (3 to 15 locations). The authors conclude that periungual fibroma is suggestive of TS only when there are mul…