Periumbilical skin cyanosis: In acute pancreatitis, the overflowing pancreatic fluid contains a large amount of pancreatic enzymes spreading along the tissue interstices, which can dissolve the subcutaneous fat and cause the capillaries to rupture and bleed, resulting in cyanosis of the periumbilical skin called Cullen’s sign. In addition to purple skin around the umbilicus and the lateral abdominal wall, there can also be skin damage on the extremities in the form of purple spots, blisters and necrosis, and skin damage is one of the signs of critical condition. The abdominal wall manifestations of acute pancreatitis are part of the systemic disease, and signs and symptoms such as abdominal wall edema, pressure pain, and skin color changes can be seen clinically. Freckles: It is a simple light brown or brown skin spot, mostly growing on the face. The formation of freckles is mainly due to the excessive melanin generated by melanocytes in the basal layer of skin epidermis. 1.Small brown spots with the shape and color of a bird’s egg are called freckles. 2. Freckles are usually found on the face, neck, arms and other sun-damaged areas, and on the cheeks and bridge of the nose. The number of freckles is variable and they do not fuse with each other. 4. Generally, freckles are found at an early age, more in women than in men, often accompanied by family history and no other symptoms. Freckles are a kind of skin damage that occurs on the face, in the form of spots, or sesame-like brown or light brown small spots. The best areas are the cheeks and the bridge of the nose, but can also spread to the entire face or even the neck, and is one of the most common causes of facial aesthetics. Edematous purplish spots on both upper eyelids: A typical lesion of dermatomyositis, edematous purplish spots on both upper eyelids, spreading to the periorbital area and gradually expanding to the V-zone of the face, neck, and upper chest. The purple-red papules on the extremities of the elbows and knees, especially on the extensor side of the metacarpophalangeal and interphalangeal joints, are accompanied by dilated capillaries, hypopigmentation, and covered with fine scales, called Gottron’s sign or Grottron’s papules. 1. Skin changes: mainly sebaceous adenoma on the face. 2. Neurological signs and symptoms: epilepsy and mental retardation. 3. Ocular changes: most commonly optic papillae and retinal nodules. Diagnosis: The diagnosis of sebaceous adenoma, mental retardation and epilepsy can be confirmed by the presence of the three main signs. However, the three main signs do not always appear together in clinical practice. Sebaceous adenoma is seen in almost all patients; fundus lesions are often detected during ophthalmologic consultations after the diagnosis of sebaceous adenoma is confirmed.