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Other symptoms can include dull skin, weakness, and brain fog

Although the etiology is not well understood, many theories have elaborated on the probable involvement of inflammation

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DDIT4 promotes malignancy of head and neck squamous cell carcinoma

Adipokines secreted by dysfunctional adipose tissue, particularly molecules such as leptin and adiponectin, increase inflammation [183]

Additionally, oxidative stress can induce melanocytes to produce and secrete heat shock protein 70 (HSP70), which is associated with the activation of dendritic cells (DCs) and the induction of proinflammatory cytokines via TLR2, TLR4, or TLR2-TLR4 28,29