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The agency cited immunogenicity concerns, saying there was limited data on the quality, stability and consistency of the compounds

An intradermal test dose is recommended if there is a suspicion of allergy to cyanocobalamin

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This would allow a higher degree of efficacy when compared to tablet or capsule administration [25, 26]

Several mechanisms likely play a role in the pathogenesis of lichen sclerosuss inflammatory hypopigmentation: (1) decreased melanin production, (2) block in transfer of melanosomes to keratinocytes, and (3) melanocyte loss [56]