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While these may resemble acne, blackheads are absent, and burning or stinging may occur

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10.1001/jamacardio.2019.5954 [DOI] [PMC free article] [PubMed] [Google Scholar] 20

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This suggests that high levels of upstream lactate can override the limiting effect of p300, and it is more likely that p300 is not the sole writer of Hla and that other enzymes may be involved in this process, or even that p300 is not the primary writer for Kla (49)