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This microenvironment is of extreme importance due to its role not only as a structural, modifiable, and flexible scaffold for cells but also as a provider of a range of biochemical and biophysical signals that collectively regulate cell behaviors such as spreading, proliferation, migration, differentiation, and apoptosis [87]

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If stopping saw palmetto is not feasible or was not done before starting isotretinoin, disclose the co-use to the dermatologist at the next monthly iPLEDGE visit, request a liver-function review, and watch for unusual bruising or bleeding symptoms

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