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Note what signs you see.
I (W. Wertelecki, M.D.) see hyperpigmented melanic skin patches, some dark and other of CaL (café-au-lait) color, under these patches there are irregular areas of subcutaneous and cutaneous hypertrophy, the foot is deformed, hypertrophied, the toes and hallux are mal-positioned (deformed). In addition there is the small area of the hyperpigmented skin with a papilla-like protrusion suggestive of a local overgrowth. This is NOT an illustration of neurofibromatosis 1 (NF1). For more, see other illustrations of this patient and a suggested diagnosis – see this patient’s gallery.