My child has a black lip and the doctor told me to do a test? It’s interesting to say that a woman brought her 10-year-old child to the clinic, saying that her child had frequent stomach pains and upset stomachs, and asked me to look into the problem. When I asked for a medical history and gave the child a routine checkup, I found that the child had obvious black discoloration on the lips and oral mucosa, as well as a lot of fingers on both sides. When I looked at the child’s mother’s lips, fingers, toes and other parts of the body also had similar features; and then carefully questioned the woman, I learned that she had long-term abdominal pain, diarrhea and other gastrointestinal discomfort. So, I solemnly suggested that the two of them go for a digestive tract examination, which confused them and asked suspiciously: the child’s lips are black, but you want me to do a colonoscopy? So, I told the secret about the “dark spot polyp syndrome” …… ■ What is the dark spot polyp syndrome? Dark spot polyp syndrome (PJS), also known as pigmented polyp syndrome, is characterized by specific dark spots, multiple polyps in the stomach and intestines, and family clusters. About 50% of patients have a significant family history, which means that if one parent has the disease, there is a 1/2 chance that their children, male or female, will develop the disease. What are the clinical features of melanotic polyp syndrome? Dark spot polyp syndrome is mainly characterized by dark spots on the lips and multiple polyps in the gastrointestinal tract. 1.Specific dark spots: The most prominent feature of the disease is the dark spots on the lips and mouth. The melanin spots can appear in childhood or infancy, and the color is darkest in adolescence, and becomes lighter after middle age, but the pigment of the buccal mucosa generally persists. The dark spots are round or oval in shape and do not rise above the skin surface, do not fade with pressure, and have no hair growth. The distribution is mostly seen on the lips, gums, buccal mucosa, around the eyes of the mouth, nose and fingers, and the palm surface of the toes, and the labia and glans can also have melanin deposits. (Black spots on the lips) (Black spots on the lips, gums and cheek mucosa) 2, gastrointestinal polyps: polyps can occur in any part of the gastrointestinal tract, but most common in the small intestine, followed by the colon, rectum, stomach, very few cases can be seen in the biliary tract, urinary tract, uterus, etc.. The number of polyps varies from several to a hundred, with or without a tip, smooth surface, and can be sankan-shaped or lobulated, and are often pathologically misshapen tumors. What are the risks of melanotic polyp syndrome? The clinical manifestation of this syndrome varies and varies greatly among individuals. In mild cases, there may be no conscious symptoms, while in severe cases, abdominal pain, diarrhea, mucus stool, blood in stool, constipation, vomiting blood and other gastrointestinal symptoms may occur. There are also many patients who seek emergency care for complications caused by polyps, such as intussusception, intestinal obstruction, and bleeding. Previously, it was thought that gastrointestinal polyps are misshapen tumors, not precancerous, and there is no possibility of malignancy; however, a large number of studies have shown that patients with melanotic polyp syndrome are typically a high incidence of malignant tumors, and the incidence of various types of tumors is about 23%. What tests should be done for people at high risk of melanotic polyp syndrome? Since melanotic polyp syndrome is an autosomal dominant disease, patients with melanotic polyp syndrome should be actively followed up by themselves and their family members to detect new patients in the family for the purpose of early diagnosis and early treatment. For patients with family history or already diagnosed, gastroscopy, colonoscopy, small intestine microscopy and whole gastrointestinal barium angiography should be performed as much as possible to completely exclude polyps in the digestive tract. Starting from the age of 10, gastroscopy, colonoscopy and whole gastrointestinal barium meal should be performed once every 2 years, and small intestinal microscopy or capsule endoscopy should be performed if available. For patients with oligopolyposis type, endoscopy once a year is required after the GI polyps are cleared. (e-colonoscopy) After listening to my explanation of the disease, the woman finally accepted my suggestion: mother and son underwent gastroscopy, colonoscopy and small intestine microscopy respectively, and the final result was very unfortunate: both mother and son suffered from this particular disease: dark spot polyp syndrome.