Derm Dx: Cafe au lait macules, soft fleshy nodules and skin-colored, bag-like protrusions

A 37-year-old pregnant Hispanic woman presents for her 34-week obstetric exam. She states she has had skin problems her whole life. She had multiple café au lait macules (CALMs) when she was born and has subsequently developed multiple skin findings since she was a teenager.

On exam, the patient is well nourished, well developed and in no distress. Her ...