macula melanotica genital Mucosal melanocytic macules Clinical and Dermoscopic Features of

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Bailey-Downs LC, Sosnowska D, Toth P, Mitschelen M, Gautam T, Henthorn JC, et al

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Systemic effects less commonly include mild dizziness or lightheadedness (may be copper-related), temporary nausea or headache (typically resolves within hours), mild fatigue (rare, reported with higher doses), and transient flu-like symptoms (very rare, may relate to systemic inflammatory response)