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J Am Acad Dermatol 44:10481049 Kumar C, Sharma D, Pandita A, Shastri S (2015) Congenital lingual melanotic macule: rare entity in infants

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The demyelination is thought to result from the increase in methylmalonyl-CoA that results from vitamin B12 deficiency that is associated with loss of methylmalonyl-CoA mutase activity