You are correct. Periungual fibromas are an important sign of tuberous sclerosis complex, an autosomal dominant multisystem disorder characterized by hamartomas in multiple organs, including skin, brain, eyes, kidney, and heart. Skin lesions are found in approximately 2/3 of cases and also include facial angiofibromas (‘adenoma sebaceum’), the shagreen patch, & ash leaf-shaped macules. A CT brain confirmed the dx of tuberous sclerosis and demonstrated subependymal nodules. This case highlights the importance of performing a skin exam, particularly of the feet & hands, in any pt presenting w/ seizures.