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According to the case report, published in JAAD Case Reports, researchers described the lesions as "initially erythematous and pruritic reactions [that] subsequently progressed into asymptomatic chronic hyperpigmented patches with an erythematous border." Physical examination revealed "multiple dusky hyperpigmented round patches with erythematous borders on her buttock and abdomen." A 4-mm punch biopsy from the right buttock demonstrated "lichenoid interface dermatitis

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The above continuing reactions prevent lactic acid (LA) formation and accumulation