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Padovan, E., Mauri-Hellweg, D., Pichler, W

6 New approaches in melasma pharmacotherapy Various adverse drug reactions are associated with systemic treatment and also numerous challenges are existing regarding the skin penetration and clinical efficacy of the topical conventional formulations that are considered in melasma management

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Pathological causes of elevated B12 warrant careful consideration: Haematological disorders : Myeloproliferative neoplasms (polycythaemia vera, chronic myeloid leukaemia), acute leukaemia, and lymphoproliferative disorders can increase B12-binding proteins (transcobalamin and haptocorrin), elevating total serum B12 [3] Liver disease : Hepatocellular damage releases stored B12 into circulation