The discovery that the G2019S mutation results in a constitutive two- to threefold increase in LRRK2 kinase activity [141, 142], along with evidence that LRRK2 mutations are risk factors for the more common sporadic form of PD [143, 144], prompted extensive investigation into its functional role
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Prescribers can adjust hydroquinone beyond the commercial 4% ceiling (up to 8% for refractory cases), swap the steroid component based on patient sensitivity, add tranexamic acid or cysteamine for resistant pigmentation, and choose vehicle bases optimized for different skin types and climates
