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In these patients, long-term therapy is needed to improve outcomes, with isotretinoin being effective in further reducing inflammatory lesions count and in maintaining remission

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43 The relevance of this pathway for tumorigenesis is demonstrated by the fact that humans with the Laron syndrome, a recessively inherited defect in the growth hormone receptor, display extremely low IGF-1 and reduced insulin concentrations and usually do not develop cancer despite high prevalence of obesity and dyslipidemia