Lobular depigmentation is mostly seen in tuberous sclerosis as one of its clinical manifestations, which are oval, striated lobular hypopigmented spots. Tuberous sclerosis (TSC), also known as Bourneville’s disease, is an autosomal dominant neurocutaneous syndrome, and there are also disseminated cases, mostly caused by abnormal development of organs in the ectodermal tissues, which can present with multi-organ involvement of brain, skin, peripheral nerves, kidneys, etc. Clinical features are facial sebaceous adenoma, seizures and mental retardation. The incidence is about 1/6000 live infants, with a male to female ratio of 2:1. Different antiepileptic drugs can be used for epilepsy depending on the age of the patient and the type of seizure, and carbamazepine can be used for epilepsy starting with focal freak episodes. The disease is a genetic disorder and can be classified into four types according to genetic location: TSC1, TSC2, TSC3, and TSC4. Mutations in TSC1 and TSC2 cause abnormalities in the function of misfolded tumor proteins and nodular proteins, respectively, affecting their cellular differentiation and regulation, resulting in abnormal growth and differentiation of ectodermal, mesodermal, and endodermal cells. The mode of inheritance is autosomal dominant, with approximately one-third of familial cases, in which the mutated TSC1 or TSC2 gene is inherited from one parent, and approximately two-thirds of disseminated cases, in which patients are born with a newly mutated TSC1 or TSC2 gene and no family member has the disease. Familial patients with TSC1 mutations are more common, while sporadic patients with TSC2 mutations are more common.