Xeroderma Pigmentosum

着色性干皮病
  • 文章类型: Meta-Analysis
    背景和目的:核苷酸切除修复(NER),研究最广泛的DNA修复机制,负责修复各种DNA损伤,和着色性干皮病(XP)基因参与NER。在这里,我们旨在通过评估XPA相关性的荟萃分析来更新以前的结果,XPB/ERCC3、XPF/ERCC4和XPG/ERCC5多态性与HNC易感性有关。材料和方法:PubMed/Medline,WebofScience,Scopus,和CochraneLibrary数据库的搜索没有任何限制,直到2023年11月18日,寻找相关的研究。ReviewManager5.3(RevMan5.3)软件用于计算效果大小,以比值比(OR)表示,置信区间为95%(CI)。结果:19篇文章参与了系统评价和荟萃分析,其中包括涉及10个多态性的39项研究。结果表明,rs17655多态性CC基因型在隐性模型中显示出HNC的风险显着降低(OR:0.89;95CI:0.81,0.99;p值为0.03)。此外,rs751402多态性的CT基因型(OR:0.65;95CI:0.48,0.89;p值为0.008)与风险降低相关,和T等位基因(OR:1.28;95CI:1.05,1.57;p值为0.02),TT(OR:1.74;95CI:1.10,2.74;p值为0.02),TT+CT(OR:2.22;95CI:1.04,4.74;p值为0.04)基因型与HNC风险增加相关。结论:分析确定了两个多态性,rs17655和rs751402与HNC的风险显著相关。这项研究强调了各种因素的影响,比如癌症的类型,种族,控制源,以及这些关联的样本量。
    Background and Objectives: Nucleotide Excision Repair (NER), the most extensively researched DNA repair mechanism, is responsible for repairing a variety of DNA damages, and Xeroderma Pigmentosum (XP) genes participate in NER. Herein, we aimed to update the previous results with a meta-analysis evaluating the association of XPA, XPB/ERCC3, XPF/ERCC4, and XPG/ERCC5 polymorphisms with the susceptibility to HNC. Materials and Methods: PubMed/Medline, Web of Science, Scopus, and Cochrane Library databases were searched without any restrictions until 18 November 2023 to find relevant studies. The Review Manager 5.3 (RevMan 5.3) software was utilized to compute the effect sizes, which were expressed as the odds ratio (OR) with a 95% confidence interval (CI). Results: Nineteen articles were involved in the systematic review and meta-analysis that included thirty-nine studies involving ten polymorphisms. The results reported that the CC genotype of rs17655 polymorphism showed a significantly decreased risk of HNC in the recessive model (OR: 0.89; 95%CI: 0.81, 0.99; p-value is 0.03). In addition, the CT genotype (OR: 0.65; 95%CI: 0.48, 0.89; p-value is 0.008) of the rs751402 polymorphism was associated with a decreased risk, and the T allele (OR: 1.28; 95%CI: 1.05, 1.57; p-value is 0.02), the TT (OR: 1.74; 95%CI: 1.10, 2.74; p-value is 0.02), and the TT + CT (OR: 2.22; 95%CI: 1.04, 4.74; p-value is 0.04) genotypes were associated with an increased risk of HNC. Conclusions: The analysis identified two polymorphisms, rs17655 and rs751402, as being significantly associated with the risk of HNC. The study underscored the influence of various factors, such as the type of cancer, ethnicity, source of control, and sample size on these associations.
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  • 文章类型: Case Reports
    DeSanctis-Cacchione综合征(DCS)以前被称为干皮症,其特征是皮肤光敏性,小头畸形,智力迟钝,身材矮小,性腺功能减退,痉挛,周围神经病变和感音神经性耳聋。在这里,我们介绍了一个4岁半的男性儿童,其特征是严重急性营养不良(SAM),具有典型的鸟类样面部和凹陷的眼睛,从6个月的很小的年龄开始,在暴露于阳光的区域就有光敏性瘙痒色素皮肤病变的病史。总体发育迟缓,共济失调,小头畸形,身材矮小,检查发现性腺功能减退和恶病质消瘦,并从生化特征记录高转氨酶血症和甲状腺功能减退。随后的视觉诱发反应和脑干诱发反应测听显示前视通路功能障碍和双侧深度感觉神经性听力损失。除了脑脑萎缩和脱髓鞘外,脑的磁共振成像还产生了具有质量效应的硬膜下积液。皮肤活检进一步检测到增生异常和鳞状细胞癌(SCC)的早期体征。尽管世界各地很少有零星报道病例,据我们所知,迄今为止,印度医学文献中仅完整报道了11例此类病例,这使我们的病例报告为第12例,与硬膜下积液有独特的新关联。
    De Sanctis-Cacchione syndrome (DCS) formerly known as xerodermic idiocy is characterised by cutaneous photosensitivity, microcephaly, mental retardation, short stature, hypogonadism, spasticity, peripheral neuropathy and sensorineural deafness. Here in, we present the case of a four and half years old male child with features of severe acute malnutrition (SAM) with a typical bird like facies and sunken eyes who had history of photosensitive pruritic pigmentary skin lesions on sun exposed areas from a very early age of six months. Gross developmental delay, ataxia, microcephaly, short stature, hypogonadism and cachectic wasting were identified on examination and hypertransaminasemia and hypothyroidism were recorded from biochemical profile. Subsequent visual evoked response and brainstem evoked response audiometry revealed anterior visual pathway dysfunction and bilateral profound sensorineural hearing loss. Magnetic resonance imaging of brain yielded subdural effusion with mass effect in addition to cerebro-cerebral atrophy and demyelination. Skin biopsy further detected dysplastic changes and early signs of squamous cell carcinoma (SCC). Although few cases are reported sporadically throughout the world, to our best of knowledge till date only 11 such cases have been reported completely in Indian medical literature which makes our case report the 12th one with distinctive novel association of subdural effusion.
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  • 文章类型: Review
    背景:着色性干皮病(XP)是一种罕见的常染色体隐性遗传病,表现为无法修复紫外线诱导的DNA损伤。这可能导致影响多器官系统的肿瘤的发展,通常在童年发病。不幸的是,XP目前没有治愈方法,管理策略侧重于防晒和恶性肿瘤的早期干预。尽管XP患者的大多数皮肤问题都是由紫外线引起的,还描述了各种口腔病变。然而,文献尚未广泛描述口腔表现及其预后意义。
    方法:我们进行了全面综述,以评估儿科XP患者口腔粘膜病变的患病率和性质。
    结果:我们的文献检索获得了130名患有口腔受累的儿童XP患者和210名相关的肿瘤或非肿瘤病变。据报道,鳞状细胞癌是最常见的口腔粘膜肿瘤类型,包括基底细胞癌在内的其他恶性肿瘤,黑色素瘤,血管肉瘤,纤维肉瘤,和毛膜癌。
    结论:考虑到XP患者口腔黏膜肿瘤的潜在发病率和死亡率,我们的研究旨在提高人们对这些表现的认识。早期诊断和治疗对于有效管理这些病变至关重要,常规口腔检查应被视为XP患者皮肤病学评估的关键组成部分,尤其是在儿科年龄组。
    BACKGROUND: Xeroderma pigmentosum (XP) is a rare autosomal recessive disorder presenting with an inability to repair UV-induced DNA damage. This can lead to the development of neoplasms affecting multiple organ systems, with onset often in childhood. Unfortunately, no cure currently exists for XP, and management strategies focus on sun protection and early intervention for malignancies. Although most skin problems in XP patients are UV induced, various oral lesions are also described. However, the literature has not extensively characterized the oral manifestations and their prognostic significance.
    METHODS: We conducted a comprehensive review to evaluate the prevalence and nature of oral mucosal lesions in pediatric XP patients.
    RESULTS: Our literature search yielded 130 pediatric XP patients with oral involvement and 210 associated tumoral or non-tumoral lesions. Squamous cell carcinoma was the most common type of oral mucosal tumor reported, with other malignancies including basal cell carcinoma, melanoma, angiosarcoma, fibrosarcoma, and trichilemmal carcinoma.
    CONCLUSIONS: Given the potential morbidity and mortality associated with oral mucosal tumors in XP patients, our study aims to raise awareness of these manifestations. Early diagnosis and treatment are crucial for managing these lesions effectively, and routine oral exams should be considered a critical component of dermatological evaluations for XP patients, especially in the pediatric age group.
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  • 文章类型: Journal Article
    鉴于角膜缘干细胞功能不全的各种眼部表现,对基因的认识,收购,和免疫学原因以及相关的角膜缘干细胞缺乏症(LSCD)的其他治疗对于提供者至关重要。我们对LSCD的各种病因和具体疗法的文献进行了全面回顾。本次审查中使用的资源包括Medline(PubMed),Embase,谷歌学者。本研究回顾了1986年11月至2022年10月发表的所有英文文章和病例报告。共有99篇关于这些主题的文章。未应用其他排除标准。根据病因,角膜缘干细胞缺乏的眼部表现范围从干眼综合征和红肿到更严重的结果,包括角膜溃疡,眼表失效,和视力丧失。确定LSCD的损伤源在治疗过程中至关重要,鉴于治疗可能超出标准协议的范围,包括人工泪液,屈光手术,和同种异体干细胞移植。这篇全面的文献综述证明了各种遗传,收购,LSCD的免疫学原因和可用的补充疗法的范围。
    Given the various ocular manifestations of limbal stem cell insufficiency, an awareness of the genetic, acquired, and immunological causes and associated additional treatments of limbal stem cell deficiency (LSCD) is essential for providers. We performed a comprehensive review of the literature on the various etiologies and specific therapies for LSCD. The resources utilized in this review included Medline (PubMed), Embase, and Google Scholar. All English-language articles and case reports published from November 1986 through to October 2022 were reviewed in this study. There were collectively 99 articles on these topics. No other exclusion criteria were applied. Depending on the etiology, ocular manifestations of limbal stem cell deficiency range from dry eye syndrome and redness to more severe outcomes, including corneal ulceration, ocular surface failure, and vision loss. Identifying the source of damage for LSCD is critical in the treatment process, given that therapy may extend beyond the scope of the standard protocol, including artificial tears, refractive surgery, and allogeneic stem cell transplants. This comprehensive review of the literature demonstrates the various genetic, acquired, and immunological causes of LSCD and the spectrum of supplemental therapies available.
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  • 文章类型: Case Reports
    着色性干皮病(XP)是一种罕见的常染色体隐性遗传病,其特征是强烈的皮肤光敏性,通常与角膜溃疡有关,红斑,阳光照射区域的恶性病变,严重的神经损伤。XP是由于核苷酸切除修复系统的改变,该系统可以消除被紫外线辐射破坏的DNA片段。我们报告了一例14岁因畏光和结膜肿块入院的病例。他接受了实验室检查,包括全血细胞计数(CBC),这并不引人注目,血清学检测如快速血浆反应素(RPR)和人类免疫缺陷病毒(HIV)检测均为阴性。要求进行眼科咨询,结论为双侧角膜营养不良。几个月后,他出现了两个肿块,一个在舌头的远端边界,另一个在腮腺区域的水平。他接受了两次切除活检;腮腺肿块在着色性干皮病的背景下显示出溃疡性鳞状细胞癌,舌尖肿块显示分化良好的浸润性疣状癌,边缘光滑。着色性干皮病是一种罕见的遗传性皮肤病,影响皮肤,眼睛和口腔。它有时与内脏器官的癌症有关,很少与舌头有关。本研究报告1例XP与舌疣状癌和眼部并发症相关。目前,XP没有治疗方法,唯一可用的治疗方法是对症和预防。
    Xeroderma pigmentosum (XP) is a rare autosomal recessive genetic disorder characterized by intense skin photosensitivity that is often associated with corneal ulceration, erythema, malignant lesions in sun-exposed areas, and neurological damage in severe cases. XP is due to alterations in the nucleotide excision repair system which could eliminate DNA fragments damaged by ultraviolet radiation. We report a case of a 14-year-old admitted for photophobia and a conjunctival mass. He underwent laboratory tests, including a complete blood count (CBC), which was unremarkable, and serological tests such as rapid plasma reagin (RPR) and human immunodeficiency virus (HIV) test were negative. A consultation in Ophthalmology was requested, concluding in bilateral corneal dystrophy. A few months later he developed two masses, one on the distal border of the tongue and the other at the level of the parotid region. He underwent two excisional biopsies; the parotid mass revealed an ulcerated squamous cell carcinoma on a background of xeroderma pigmentosum, and the tongue tip mass revealed a well-differentiated infiltrating verrucous carcinoma with a smooth margin. Xeroderma pigmentosum is a rare genodermatosis affecting the skin, eyes and oral cavity. It is sometimes associated with cancers of internal organs and rarely of the tongue. This study reports a case of XP associated with verrucous carcinoma of the tongue and ocular complications. Currently, there is no curative treatment for XP, and the only treatments available are symptomatic and preventive.
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  • 文章类型: Case Reports
    着色性干皮病(XP)是一种罕见的遗传病,重要的预后取决于癌症的发生,主要是皮肤和眼表,需要早期和适应的管理。放射治疗(RT)是一种非常有效的治疗方法,但它仍然没有得到充分利用,因为它被错误地认为对这些患者有害。在这篇文章中,我们报道了一例10岁接受XP治疗的右眼结膜鳞状细胞癌(SCC)的女孩。临床耐受性良好,我们获得了良好的肿瘤反应。因此,RT在这些患者中的位置可以/应该重新考虑,尤其是这些怀疑尚未得到证实。
    Xeroderma pigmentosum (XP) is a rare genetic disease, which vital prognosis is conditioned by the occurrence of cancers essentially of the skin and ocular surfaces, requiring an early and adapted management. Radiation therapy (RT) is a very effective modality in the therapeutic arsenal alongside surgery, but it remains underused as it is wrongly considered to be deleterious for these patients. In this article, we report the case of a 10-years-old girl with XP treated with external beam RT for a squamous cell carcinoma (SCC) of the right ocular conjunctiva. The clinical tolerance was excellent and we obtained a good tumoral response. Therefore, the place of RT in these patients could/should be reconsidered, especially since these suspicions have still not been confirmed.
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  • 文章类型: Journal Article
    着色性干皮病(XP)是一种罕见的常染色体隐性遗传疾病,其特征是紫外线辐射诱导的损伤修复,在许多其他人中,早期的皮肤癌。这篇系统的综述集中在临床之间的相关性,病态,XP和皮肤癌的遗传方面。
    通过在线数据库PubMed的文献检索进行了系统评价,科克伦图书馆,SciELO,谷歌学者。搜索词为“着色性干皮病”,\"XP\",\"XPC\",“核苷酸切除修复”,\"NER\",\"POLH\",“干性色素性皮肤”,和“紫外线敏感综合征”与“皮肤癌”术语啮合,\"黑色素瘤\",和“NMSC”。
    经过504份摘要筛选,对13篇全文文章进行了资格评估,其中3人被排除在外。选择了十篇文章进行定性评估。
    XP患者通常由于皮肤癌和神经退行性疾病而寿命较短。不同基因等位基因的缺失/改变可以产生不同类型的癌症。与其他补体组的患者相比,XPC和XP-E变体更容易患皮肤癌,这些患者最常见的死亡原因是皮肤癌(转移性黑色素瘤或侵袭性SCC)。尽管如此,积极的预防措施,以尽量减少紫外线辐射暴露可以延缓疾病的进程,提高生活质量。
    UNASSIGNED: Xeroderma pigmentosum (XP) is a rare autosomal recessive disorder of UV radiation-induced damage repair that is characterized by photosensitivity and a propensity for developing, among many others, skin cancers at an early age. This systematic review focused on the correlation between the clinical, pathological, and genetic aspects of XP and skin cancer.
    UNASSIGNED: A systematic review was conducted through a literature search of online databases PubMed, Cochrane Library, SciELO, and Google Scholar. Search terms were \"Xeroderma pigmentosum\", \"XP\", \"XPC\", \"Nucleotide excision repair\", \"NER\", \"POLH\", \"Dry pigmented skin\", and \"UV sensitive syndrome\" meshed with the terms \"Skin cancer\", \"Melanoma\", and \"NMSC\".
    UNASSIGNED: After 504 abstracts screening, 13 full-text articles were assessed for eligibility, and 3 of them were excluded. Ten articles were selected for qualitative assessment.
    UNASSIGNED: Patients with XP usually suffer shorter lives due to skin cancer and neurodegenerative disease. Deletion/alteration of a distinct gene allele can produce different types of cancer. The XPC and XP-E variants are more likely to have skin cancer than patients in other complement groups, and the most common cause of death for these patients is skin cancer (metastatic melanoma or invasive SCC). Still, aggressive preventative measures to minimize UV radiation exposure can retard the course of the disease and improve the quality of life.
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  • 文章类型: Journal Article
    UNASSIGNED:早期识别着色性干皮病对于最大程度地减少因暴露于紫外线辐射的有害影响而引起的并发症非常重要。这篇叙述性综述旨在使医生熟悉临床特征,色素干皮病的诊断和治疗。
    UNASSIGNED:于2021年12月在PubMed临床查询中使用关键术语“着色性干皮病”进行了搜索。搜索策略包括所有临床试验,过去10年发表的观察性研究和评论。在本文的汇编中使用了从搜索中检索到的信息。
    UASSIGNED:着色性干皮病是紫外线辐射引起的DNA修复异常和氧化性DNA损伤的一种情况,导致皮肤癌易感性增加.大约50%的着色性干皮病患者的光敏性增加,某些类型的着色性干皮病更容易发生眼部疾病和进行性神经变性,这取决于致病突变。在光敏性增加和特征性皮肤的患者中,应怀疑诊断。眼科和神经系统的发现。可以通过鉴定其中一个致病基因中的双等位基因突变来做出明确的诊断。严格和一致的避免阳光和保护以及早期发现和治疗癌前和恶性皮肤病变是管理的主要内容。光化性角化病的治疗选择包括冷冻疗法,局部咪喹莫特,外用5-氟尿嘧啶,化学剥离,切除,CO2激光重铺,分数/脉冲激光治疗,和光动力疗法。皮肤恶性肿瘤可以通过光动力疗法治疗,刮治和电干燥,或者手术切除.口服异维A酸,口服烟酰胺,局部咪喹莫特和局部氟尿嘧啶可用于预防皮肤恶性肿瘤。变黄病的治疗选择包括化学剥离,磨皮和激光重修。甲基纤维素滴眼液和柔软的紫外线防护隐形眼镜可用于保持角膜湿润并防止干燥性角膜炎的有害影响。研究疗法包括使用T4核酸内切酶-V脂质体洗剂和口服烟酰胺来降低光化性角化病和非黑素瘤皮肤癌的发生率,以及用于根治这种疾病的基因疗法。
    未经授权:虽然目前还没有治疗色素性干皮病的方法,提高对病情的认识和早期诊断,其次是严格的防晒和保护以及优化管理,可以大大提高生活质量和预期寿命。
    UNASSIGNED: Early recognition of xeroderma pigmentosum is important to minimize the complications arising from the harmful effects of exposure to ultraviolet radiation. This narrative review aims to familiarize physicians with the clinical features, diagnosis and management of xeroderma pigmentosum.
    UNASSIGNED: A search was conducted in December 2021 in PubMed Clinical Queries using the key term \"xeroderma pigmentosum\". The search strategy included all clinical trials, observational studies and reviews published within the past 10 years. The information retrieved from the search was used in the compilation of this article.
    UNASSIGNED: Xeroderma pigmentosum is a condition of abnormal DNA repair of ultraviolet radiation-induced and oxidative DNA damage, which leads to increased skin cancer susceptibility. Approximately 50% of patients with xeroderma pigmentosum have increased photosensitivity and certain types of xeroderma pigmentosum are more prone to ocular disease and progressive neurodegeneration depending on the causative mutation. The diagnosis should be suspected in patients with increased photosensitivity and characteristic cutaneous, ophthalmological and neurological findings. A definite diagnosis can be made by the identification of biallelic mutation in one of the causative genes. Strict and consistent sun avoidance and protection and early detection and treatment of premalignant and malignant skin lesions are the mainstays of management. Treatment options for actinic keratosis include cryotherapy, topical imiquimod, topical 5-fluorouracil, chemical peeling, excision, CO2 laser resurfacing, fractional/pulsed laser therapy, and photodynamic therapy. Cutaneous malignancy can be treated by photodynamic therapy, curettage and electrodesiccation, or surgical excision. Oral isotretinoin, oral niacinamide, topical imiquimod and topical fluorouracil can be used for the prevention of skin malignancy. Treatment options for poikiloderma include chemical peeling, dermabrasion and laser resurfacing. Methylcellulose eyedrops and soft ultraviolet-protective contact lenses may be used to keep the cornea moist and protect against the harmful effects of keratitis sicca. Investigational therapies include the use of T4 endonuclease-V liposome lotion and oral nicotinamide to reduce the rate of actinic keratoses and non-melanoma skin cancers and gene therapy for radical cure of this condition.
    UNASSIGNED: Although currently there is no cure for xeroderma pigmentosum, increased awareness and early diagnosis of the condition, followed by rigorous sun avoidance and protection and optimal management, can dramatically improve the quality of life and life expectancy.
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  • 文章类型: Journal Article
    着色性干皮病(XP)是一种罕见的遗传性疾病,由于受影响患者的高光敏感性,预后较差。在这里,我们描述了在XP患者中使用cemiplimab的第一例,一名19岁女孩出现右眶周和鼻部局部晚期鳞状细胞癌。这种治疗是在质子束放射治疗循环后进行的。此外,据报道,在XP患者中,有少数病例描述了免疫治疗对皮肤癌的有效性.这个案子和报道的是一致的,强调抗PD1单克隆抗体可能是这种遗传性皮肤病的有希望的治疗方法。
    Xeroderma Pigmentosum (XP) is a rare genetic disorder with a poor prognosis due to high photosensitivity in affected patients. Herein, we describe the first case of the use of cemiplimab in a patient with XP, a 19-year-old girl presented with locally advanced squamous cell carcinoma of the right periorbital and nasal region. This treatment has been undertaken after a cycle of proton beam radiotherapy. Besides, it is reported a description of the few cases in the literature describing the effectiveness of immunotherapy on skin cancers in XP-patients. This case is in line with those reported, underlining how anti-PD1 monoclonal antibodies may be a promising treatment in this genodermatosis.
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  • 文章类型: Journal Article
    UNASSIGNED: To describe the risk factors, clinical presentation, management, and outcomes of patients with bilateral ocular surface squamous neoplasia (OSSN).
    UNASSIGNED: Retrospective case series.
    UNASSIGNED: Of the 25 patients with bilateral OSSN, the mean age at diagnosis of OSSN was 31 years (median, 24 years; range, 2-60 years). Risk factors for bilateral OSSN included xeroderma pigmentosum (n = 15, 60%), human immunodeficiency virus infection (n = 3, 12%), conjunctival xerosis (n = 1, 4%), and topical steroid use (n = 1, 4%). There were no identifiable ocular or systemic risk factors in 7 (28%) patients. Presentation was synchronous in 14 (56%) and metachronous in 11 (44%) patients. Tumor morphology was bilaterally similar in 12 (48%) patients. Histopathological examination (n = 36) revealed conjunctival intraepithelial neoplasia (CIN) grade 1 in 4 (8%); grade 2 in 7 (14%); carcinoma in situ in 5 (10%), and invasive carcinoma in 20 (40%). Primary management of OSSN (n = 49) included excisional biopsy (n = 31, 62%), topical immunotherapy (IFN α2B) (n = 11; 22%), topical Mitomycin C (MMC) (n = 3, 6%), enucleation (n = 1, 2%), orbital exenteration (n = 2, 4%), and plaque brachytherapy (PBT) (n = 1, 2%). One patient was lost to follow-up after detection of tumor in the second eye. Recurrent tumors were noted in 16 (32%) eyes and binocular globe salvage was achieved in 16 (64%) patients at a mean follow up of 41 months (median 30 months; range, 1-164 months).
    UNASSIGNED: OSSN occurrence can be synchronous or metachronous. Meticulous examination of the fellow eye is important for an early diagnosis of OSSN.
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