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Additionally, oxidative stress and autoimmunity in vitiligo create a less favorable microenvironment for the development of skin cancer, including melanoma.75 Environmental agents as disease activators Environmental factors influence the onset or worsening of vitiligo in susceptible individuals (Table 5)

Glutathione inhibits tyrosinase enzyme activity throughout melanin production pathways

In CD38-deficient animals, NAD+ levels, mitochondrial respiratory rates, and metabolic activities remained constant with age (7)

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