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The hidden aspect is that the structural losses don't produce symptoms most women would immediately connect to their weight loss - until a fall, a fracture, or a DEXA scan requested for another reason creates the connection retroactively

While breakouts and acne are not listed as adverse effects in the FDA prescribing information for tirzepatide, some patients report skin changes during treatment

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20.16 Nevus of Ito appears as a large blue patch over the arm and shoulder of a child 20.10.2 Histology Histologic findings consist of a loose aggregation of densely pigmented, dendritic-shaped melanocytes within the superficial portion of the reticular dermis (Figs