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Although multiple pathways are involved in mediating tissue damage, including the polyol pathway, advanced glycation end product formation, protein kinase C activation, and the hexosamine pathway, a common feature is increased oxidative stress marked by elevated levels of reactive oxygen species (ROS) (1)

139 RehmM.HuberH

10.1038/s41375-020-1001-z 8 BandyopadhyayS.DuffyM

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Patients should keep the area clean and follow proper hygiene practices to minimize this risk