Are the spots on the lips a symptom of chronic hyperalgesia? What tests should I have? Is there any scientific basis for this statement? Thank you. There is some scientific basis, chronic hypoadrenocorticism has some clinical manifestations as follows, you can learn about them: a. Slow onset. Occasionally, in some cases, adrenal crisis is induced by infection, trauma, surgery and other stresses before it is clinically detected. Pigmentation Skin and mucous membrane pigmentation, mostly diffuse, with the exposed parts, frequently rubbed parts and finger (toe) nail roots, scars, areola, external genitalia, around the anus, gums, oral mucosa, conjunctiva as obvious. Hyperpigmentation is caused by a decrease in glucocorticoids and a weakened feedback inhibition of melanocyte-stimulating hormone (MSH) and adrenocorticotropic hormone (ACTH) secretion. Some patients may have areas of patchy depigmentation. In patients with secondary hyperaldosteronism, MSH and ACTH levels are significantly reduced, so there is no hyperpigmentation. The degree of weakness parallels the severity of the disease, from poor work tolerance in mild cases to bedridden in severe cases. It is caused by electrolyte disturbance, dehydration, protein and sugar metabolism disorder. Gastrointestinal symptoms such as loss of appetite, nausea, vomiting, epigastric, right lower abdominal or non-localized abdominal pain, sometimes with diarrhea or constipation. Most prefer high sodium diet. Often accompanied by wasting. Gastrointestinal symptoms are mostly seen in those with long duration and severe disease. V. Cardiovascular symptoms Due to sodium deficiency, dehydration and corticosteroid deficiency, patients mostly have hypotension (systolic and diastolic blood pressure are decreased) and upright hypotension. The heart is small, the heart rate is slowed down, and the heart sound is low and dull. Due to the lack of insulin antagonistic substances in the body and gastrointestinal disorders, patients often have low blood glucose, but because of the slow development of the disease, they can mostly tolerate it and the symptoms are not obvious. There are only hunger, sweating, headache, weakness and restlessness. In severe cases, tremor, blurred vision, diplopia, mental disorders, and even convulsions and coma may occur. The disease is particularly sensitive to insulin, and even a very small dose of injection can cause severe hypoglycemic reactions. VII. Mental symptoms Mental depression, indifferent expression, memory loss, dizziness and drowsiness. Some patients have insomnia, irritability, and even delirium and psychosis. VIII. Adrenal crisis Patients with low resistance, any stress load such as infection, trauma, surgery, anesthesia, etc. can induce acute hyperalgesic crisis. Nine, other sensitive to anesthetics, sedatives, a small dose can cause drowsiness or coma. Hypogonadism, such as impotence, menstrual disorders, etc. X. Primary manifestations such as tuberculosis, various autoimmune diseases and various symptoms of glandular failure syndrome. Special laboratory tests include: (i) urinary 17 hydroxycorticosteroids (17OHCS) and 17 ketocorticosteroids (17KS) (ii) plasma cortisol measurement, which is mostly significantly reduced and the circadian rhythm disappears. (iii)ACTH excitation test