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Vasc.Med 2012;17(3):145-154
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Patients may consider reducing caffeine, nicotine, energy drinks, and other stimulants, especially if twitching is worse after using them
The mechanisms by which certain medications bring about oral mucosal melanin hyperpigmentation include upregulation of tyrosinase activity, deposition of complexes of the drug with pre-existing melanin in the mucosa, or induction of local inflammatory reactions with the triggering of melanin production [11, 38]
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