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Studies following major weight loss have documented that changes in perceived attractiveness, social visibility, or interpersonal roles can introduce new tensions or amplify pre-existing patterns [79,80,81]

Afamelanotide is FDA-approved for EPP at 16 mg subcutaneous implant every 60 days roughly 2 mg/day of continuous release (Langendonk et al., 2015)

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Environmental factors and gene interactions also play a role