Please click to enlarge.
Note what signs you see.
I (E. Patskun, M.D.) see a large café-au-lait patch with irregular borders (like the coast of the state of Maine in the United States).
PERSPECTIVE: This is a classic example of the importance of “Semiology”, the science and art of transforming signs (the characteristics of the observed patch) into a signal. In my judgement without knowing other concurrent signs, the diagnosis of NF1, which often is associated with pigmentary changes exactly on this area of the face. Nonetheless, in my view this is not an instance of NF1. The sign is a skin patch with light melanic pigmentation with irregular edges. In NF1, the patches on this area have smooth or no edges and the pigmentation is not uniform – some areas are darkly pigmented – often the area is warmer and swollen.
Please also see the gallery of NF1 signs.