20 year old woman with hyperpigmented patches

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A 20 year old woman presented to our opd on 19/8/2021 with the complaints 
Hyperpigmentation of her lips since 1 year
Hyperpigmented patches on cheeks and upper limbs since 3 months 

20 year old woman, who noticed a hypopigmented patch measuring 1cm into 1cm on her forehead 10 years back after which she consulted a doctor and was diagnosed with leprosy and has been on treatment since 10 years.

Since 1 year she has been having hyperpigmentation of her lips. Since the past 3 months she has also noticed hyperpigmented patches on her face following which she developed similar patches on her chest and her bilateral upper limbs. She says these are aggravated post exposure to sun light. 

She says these lesions are itchy and scrap on scratching.

She was advised skin biopsy on 8/8/2021 and ANA levels by our dermatology department.

SKIN BIOPSY REPORT:
Serum ANA turned out to be 173 (raised)

Her other routine investigations were normal except for hemoglobin which was 8.7g/dl. 
Peripheral smear showed microcytic hypochromic picture with reduced MCV, pointing towards Iron deficiency anemia. Started her on Tab Orofer XT and advised for Serum Reticulocyte count and Ferritin levels

Since the beginning of this month she has been on Prednisolone 40mg which has been tapered to Tab Prednisolone 15mg which she has been on since the past 3 days.

Will be updating her father follow up visits

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