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2.1 Autoimmune comorbidities Patients with vitiligo are more likely to have cutaneous and extra-cutaneous immune-mediated comorbidities compared to the general population

Upon activation, neutrophils release various inflammatory mediators, including cytokines, chemokines, and ROS, which exacerbate liver inflammation [45, 77, 78]

-Hydroxy acids and retinoids added to assist lightening, and the steroidal or other anti-inflammatory ingredients added to control irritancy may cause the skin to thin and further increase susceptibility to inflammation and photodamage

Experimental research suggests that retinoic acid can influence ceruloplasmin synthesis, but vitamin A is only one part of the pathway