5Electron microscopic picture shows that the hyperchromic macules contain numerous fully melanized melanosomes forming melanosome complexes, but the melanosomes are absent from both keratinocytes and melanocytes in the achromic
Major Criteria Minor Criteria Facial angiofibromas or Multiple randomly distributed forehead plaque pits in dental enamel Ungual or periungual fibroma Hamartomatous rectal polyps (Non-traumatic) Bone cysts Hypomelanotic macules (>3) Cerebral white matter Shagreen patch (connective migration tracts tissue naevus) Gingival fibromas Cortical tuber Nonrenalhamartoma Subependymal nodule Retinal achromic
patch Subependymal giant cell astrocytoma Confetti skin lesions Multiple retinal nodular hamartomas Multiple renal cysts Cardiac rhabdomyoma, single or multiple Nonrenal hamartomas Pulomary lymphangiomyomatosis Renal angiomyolipoma.
Minor clinical criteria include multiple randomly distributed pits in dental enamel, hamartomatous rectal polyps, bone cysts, cerebral white matter radial migration lines, gingival fibromas, nonrenal hamartoma, retinal achromic
patch, "'confetti" skin lesions, and multiple renal cysts.