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The typical manifestations of photoaged skin include a leather-like appearance in areas exposed to UV light, characterized by dense localized wrinkles along with common pigmentation spots and erythema (3, 4)

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The slides were then stored in a humidified container and analyzed within 24 h

10.1016/j.jhep.2011.02.011 58 GongM

The American Academy of Family Physicians and NIH identify the following clinical manifestations: Fatigue and generalized weakness Megaloblastic anemia (abnormally large, immature red blood cells) Tingling or numbness in the hands and feet (peripheral neuropathy) Difficulty walking and balance problems Cognitive disturbances including memory difficulty and confusion Mood changes, including depression and irritability Glossitis (swollen, inflamed tongue) Early symptoms such as fatigue and mild tingling are often attributed to stress, aging, or other conditions

Conflict of interest Author YC was employed by Power China Chengdu Engineering Corporation Limited