A 35-year-old male is seen in the follow up clinic. He
has an inherited condition for which he attends yearly follow up.
On examination, he has 8 café-au-lait macules of over 15
mm in greatest diameter on his trunk, he has multiple discrete skin nodules
distributed over his trunk and limbs and there is freckling in the axillae.
The patient is worried about his child; a boy of 6. He
was told that examination of the child could conclusively exclude inheritance
of this condition in the child but he has forgotten what the exclusion
criteria were. He asks you to reiterate them and your reply is that this
condition may be confidently excluded if:
The child does not have any café-au-lait macules
If the child has fewer than 6 café-au-lait spots
If the child has no axillary freckling
If the child has no skin nodules
If no member of the mother’s family have been affected