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Emerging evidence also indicates that autophagy plays a critical role in several organs, particularly in highly metabolic organs, and that its alteration is involved in the pathogenesis of metabolic disease, immunity and autoimmunity, inflammation, development, aging and cancer (19,20)

Hutchinson described the evolution of pigmented spots with malignant potential as follows: Usually appearing as brown spots on the eyelids of elderly people, later becoming black and enlarging in size

Researchers could use surveys or diaries to track frequency, severity, and the impact on daily life