What findings are most characteristic of Neurofibromatosis Type 1?

• A. Hemangiomas and port-wine stain
• B. Café-au-lait spots and soft, fleshy skin tumors
• C. Bullous lesions with negative Nikolsky
• D. Targetoid lesions on palms

Answer: (B)

Neurofibromatosis type 1 most characteristically presents with a combination of café-au-lait spots and soft, fleshy skin tumors called neurofibromas. Café-au-lait spots are flat, evenly pigmented brown patches that often appear in early childhood; when there are several (six or more in a child, or a characteristic pattern), they strongly point to NF1. Neurofibromas are benign nerve sheath tumors that grow as soft, nodular or pedunculated lesions on or under the skin and tend to increase with age. Together, these findings form the classic skin signature of NF1.

Other options describe findings more typical of different conditions: vascular malformations like port-wine stains point toward Sturge-Weber; bullous lesions with negative Nikolsky suggest bullous diseases such as pemphigoid or pemphigus; targetoid palms are associated with erythema multiforme.