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Diabetes Obes Metab 2021;23:529 137

Retinaldehyde is then oxidized to generate retinoic acid in the presence of the aldehyde dehydrogenase 1 (ALDH1) family enzyme, which is then converted into the product 4-oxo retinoic acid

Unfortunately, in the setting of low- to intermediate-income countries with limited resources, patients are frequently referred to tertiary cancer centers when the disease has already rapidly progressed locally, most likely due to possible contamination by a wrong open biopsy or nononcological surgical procedure