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Melanocytes are capable of producing both eumelanin and pheomelanin, and the proportion of the two melanins produced by a particular melanocyte is a function of availability of tyrosine, of reducing agents, and of the types of pigment enzymes expressed[1]

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There is concern about the accumulation of endogenous neurotoxins (NH3) in patients with a Child B or C classification or with decompensated cirrhosis