Correct Answer: A Ash-leaf hypopigmented macule

 

Explanation:

Ash-leaf macules are the earliest finding. Retinal hamartomas, Lymphangiomyomatosis and periungual fibromas also occur with Tuberous Sclerosis. Bulbar telangiectasias are seen in Ataxia-telangiectasia.

Reference: Genodermatoses. Spitz. 2nd ed. p88.