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If a patient has both pernicious anaemia and a bariatric procedure, their B12 deficiency is essentially guaranteed without parenteral supplementation

The immune response commences early during penetration in the epidermis, with HLA-DR+ cells, likely Langerhans cells, having been shown to aggregate at the sight of infection within 48 h, while keratinocytes respond to penetration by the release of the proinflammatory cytokines IL-1 and IL-1 (77, 95)

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