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The overlying skin must adapt

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Elevated intracellular cAMP activates protein kinase A (PKA), which phosphorylates the cAMP response element-binding protein (CREB), driving transcription of melanogenesis-related genes including tyrosinase (TYR), tyrosinase-related protein 1 (TYRP1), and dopachrome tautomerase (DCT) in melanocyte models

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