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Molecular analysis of DNA extracted from affected skin identified two pathogenic somatic variants involving TSC1. Asymmetrical brain magnetic resonance imaging findings supported a diagnosis of superimposed mosaic TCS. Superimposed TSC may present with minimal systemic involvement and subtle radiological findings, contributing to potential under-recognition. Accurate classification has implications for prognosis, surveillance and genetic counselling.<\/jats:p>","DOI":"10.1093\/ced\/llag371","type":"journal-article","created":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T12:45:33Z","timestamp":1787921133000},"source":"Crossref","is-referenced-by-count":0,"title":["Superimposed mosaicism in tuberous sclerosis complex presenting as predominantly right-sided facial angiofibromas"],"prefix":"10.1093","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-8693-5808","authenticated-orcid":false,"given":"Jane","family":"Hoban","sequence":"first","affiliation":[{"name":"Department of Dermatology, University Hospital Limerick , Dooradoyle, Limerick ,","place":["Ireland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marion","family":"Leahy","sequence":"additional","affiliation":[{"name":"Department of Dermatology, University Hospital Limerick , Dooradoyle, Limerick ,","place":["Ireland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Logeswaran","family":"Selvarajah","sequence":"additional","affiliation":[{"name":"Department of Dermatology, University Hospital Limerick , Dooradoyle, Limerick ,","place":["Ireland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muriel","family":"Sadlier","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Bons Secours Hospital Cork , Cork ,","place":["Ireland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laoise","family":"Griffin","sequence":"additional","affiliation":[{"name":"Department of Dermatology, University Hospital Limerick , Dooradoyle, Limerick ,","place":["Ireland"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,8,28]]},"reference":[{"key":"2026092208261210300_llag371-B1","first-page":"863","article-title":"The cutaneous manifestations of tuberous sclerosis complex","volume":"43","author":"Wataya-Kaneda","year":"2018","journal-title":"Clin Exp Dermatol"},{"key":"2026092208261210300_llag371-B2","doi-asserted-by":"crossref","first-page":"100180","DOI":"10.1016\/j.xjidi.2023.100180","article-title":"Diagnosis of mosaic tuberous sclerosis complex using next-generation sequencing of subtle or unusual cutaneous findings","volume":"3","author":"Treichel","year":"2023","journal-title":"JID Innov"},{"key":"2026092208261210300_llag371-B3","doi-asserted-by":"crossref","first-page":"2022","DOI":"10.1038\/s41436-020-01066-w","article-title":"Low-level mosaicism in tuberous sclerosis complex: prevalence, clinical features, and risk of disease transmission","volume":"23","author":"Giannikou","year":"2021","journal-title":"Genet Med"},{"key":"2026092208261210300_llag371-B4","doi-asserted-by":"crossref","first-page":"332","DOI":"10.3390\/genes15030332","article-title":"The genetics of tuberous sclerosis complex and related mTORopathies: current understanding and future directions","volume":"15","author":"Man","year":"2024","journal-title":"Genes (Basel)"},{"key":"2026092208261210300_llag371-B5","doi-asserted-by":"crossref","first-page":"2511","DOI":"10.1111\/jdv.16603","article-title":"Superimposed mosaicism in tuberous sclerosis complex: a key to understanding all of the manifold manifestations?","volume":"34","author":"Happle","year":"2020","journal-title":"J Eur Acad Dermatol Venereol"},{"key":"2026092208261210300_llag371-B6","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1016\/j.pediatrneurol.2021.07.011","article-title":"International TSC Consensus Group. 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