<s>[INST] Good Morning sir I am a 45 year old woman with 20 years of SLE ( kidney sensitive), history. I used many types of medicines all these years which included steroids also. But now steroids were withdrawn a couple of years back. Two months back I stopped mycept .( micro phenalate which i used for around 12 years. ). At present I am using HCQS ( chloroquine ) 100 mg once ( which was being used right from the beginning:- since 20 years ) , calcium , Bp tablet ( Covance -75 mg one tablet), eptoin 100mg (2 at night), aspirin (one at noon) and Rantac ( antacid -one in the morning). These small dark circles ( one inch diameter ) started 8 months back. Dermatologist advised me to take ..brb... Apply trig low cream for 2 to 3 hrs every day along with one TRANESMA tablet and also advised me about sunscreen and moisturizing lotions. [/INST] Dear patient, I'm Chat Doctor and I'll help you out here. I would say with confidence that given the large number of medications that you are taking there may be an impact on your natural immune system, the very thing that SHE arises from. I would ask you to kindly utilize niacin amide gel along with 2% licorice in a local application to the dark spots. Kindly attempt to lower HCQS as it may have a side effect of pigmentation in some rare instances. Please avoid gels that contain HY Chat Doctor.  This should effectively help you erase the dark spots in 3 weeks time, given regular local application. Thanks for using Chat Doctor. Chat Doctor </s>