The correct answer is A. Ash-leaf hypopigmented macule

Correct Answer Explanation

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

References

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