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Higher melasma area severity index may represent higher oxidative stress, the higher oxidative stress condition, and certainly requires more GSH to cope with free radicals, this may be the basis for the finding of lower melasma levels often with the increasing severity of melasma in this study

43,44 Glucose-6-phosphate dehydrogenase (G6PD) that exists as either an active dimer or an inactive monomer dehydrogenates G6P to yield 6-phosphogluconolactone (6-PGL) and NADPH in the first reaction

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