Pigmented spots are finely reticulated to patchy in shape, initially light red. Later it turns to greenish gray to dark brown, mostly on the cheeks, back of the neck and other exposed areas, especially around the eyes and temporal zygomatic area is the most obvious, can be seen in congenital dyskeratosis, in the upper part of the trunk, neck, shoulders, face, abdomen and other places visible fine reticulated gray-brown pigmentation, velvet-like feeling. Also visible are skin atrophy, very pronounced capillary dilation, as if vascular atrophic skin heterochromia. The skin on the face is red and atrophic, and there may be irregular patches of pigmentation, extensive atrophy of the dorsal skin of the hands and feet with transparent shine, diffuse keratotic damage on the palms, plantars and knees and elbows, and easy formation of large blisters after trauma to the skin all over the body. Patients may sometimes have atrophic deformity changes of the skin, muscles and bones of the hands and feet. What are the laboratory tests for fine reticulate to patchy hyperpigmentation? General pathological changes 1. Epidermal atrophy with a marked increase in heterochromatic skin melanin. 2, A small number of gelatinous vesicles are visible. 3.Vacuolar degeneration of basal cells, separation of true epidermis in severe cases, intra- or subepidermal blister formation. 4.Dermal papillae are vasodilated and phagocytic pigment cells are visible, without obvious lymphocytic infiltration. Clinical features 1. Neonatal or early childhood onset, no significant gender differences. 2, May be autosomal recessive. 3. Traumatic or spontaneous macules, especially at the extremities and joints. 4. Heterochromia of the skin with progressive atrophy. 5, Photosensitivity. 6, palmoplantar hyperkeratosis. 7, often accompanied by bleeding gingivitis, abnormal tooth development, nail dystrophy, esophageal and urethral strictures. 8. Blisters gradually decrease with age.