A 7-year-old child presents with multiple light-brown oval macules on the trunk and back, the largest 3 cm in diameter. Examination also reveals axillary and inguinal freckling, four dome-shaped cutaneous neurofibromas, and bilateral Lisch nodules on slit-lamp examination. The father has similar skin lesions and a plexiform neurofibroma of the leg. The condition marked **A** in the diagram is suspected. Which of the following is NOT a recognized diagnostic criterion for this condition according to the 2021 NIH Revised Diagnostic Criteria?
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