What Should I Do About Recurring Brown and Black Spots?

Patient History: Age: 32 Chief Complaint: The patient presents with a history of recurring brown and black spots on the arms and body since the age of 9-10, occasional scrotal ulcers diagnosed at the age of 31, HPV-associated p16 strain squamous cell carcinoma at the age of 32, Medical History: - Occasional scrotal ulcers diagnosed at age 31. - HPV-associated p16 strain squamous cell carcinoma diagnosed at age 31, treated surgically with margins. - Reappearrance of genital warts after 1 year after surgery Symptoms: - Recurring brown and black spots on the arms and body since childhood, with occasional appearance and disappearance. - Thick, black, dry-textured spots on the legs. - Small white spots near the genital area and stomach. Additional Information: The patient reports that the brown and black spots on the arms and body have been present since childhood, with intermittent appearance and disappearance. These spots are more prominent in the arms and underarms, while on the legs, they are thicker and predominantly black with a dry texture. The patient has a history of scrotal ulcers at age 31, which have resolved. At age 32, the patient was diagnosed with HPV-associated p16 strain squamous cell carcinoma, which was surgically removed with margins. Despite treatment, the patient experiences recurrent genital warts. Furthermore, small white spots have been noticed near the genital area and stomach. What should be done. Its a complicated case and needs alot of study