Hypopigmented lesions unresponsive to treatment

A 41-year-old African-American woman had a two-year history of increasing numbers of hypopigmented lesions that were unresponsive to various medications. The patient reported joint pain and fatigue but no fever or malaise. At first, she could not recall any other skin problems, but then she remembered a facial lesion, present for more than a year on her cheek, which caused no symptoms but never healed. The sexual history was noncontributory because she had been in a mutually exclusive relationship for many years.

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