 Neurofibromatosis type 1 is characterized by Caffeola macules, which are dark brown or tan spots on the skin. These lesions can vary in size and color, but they typically have a light brown or tan color and are often accompanied by freckling. Neurofibromatosis type 1 is caused by mutations in the NF1 gene, which leads to low levels of melanin production in these lesions. This study found that females tend to have more Caffeola macules than males, and that the amount of melanin produced in these lesions varies depending on the type of mutation present. Additionally, patients with certain mutations in the NF1 gene are more likely to develop plexiform neurofibromas and juvenile xanthogranolomas. This article was authored by Lempreni-Nasi, Alexios-Alexopolis, Eleftheria coccinu, and others.