Complaints: A 13 year old male child complaints of multiple dark and white spots over both hands and legs since birth.

HOPI: Patient complains of hypo& hyper pigmented spots over both upper limbs and lower limbs since birth. Gardually increasing in number and size as child grows. 
No H/o itching, burning sensation, rashes, photosensitivity.
H/o fever ? Rheumatic fever previously. And on treatment at present.
Family history present ( grand father has similar complaints).
No known drug allergies.
General examination: 
Patient is conscious, coherent and coopative,
Well oriented to time,place and person.
Vitals : stable.
Wt: 54 kgs
On examination:
Multiple hypo and hyper pigmented macules noted over b/l palms, hands, forearms, legs, foots, soles.



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