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The major challenge was the exceptional hydrophobicity of the peptide segment, which was overcome by employing a solubilizing tag and optimizing the reaction conditions using hexafluoroisopropanol (HFIP) as a cosolvent

This clinical suspicion needs confirmation by biochemical tests, but subclinical cases and those with an incidentally found adrenal mass will need screening as well
Effects of conjugated equine estrogen in postmenopausal women with hysterectomy: the Women's Health Initiative randomized controlled trial
and Brown, B.I
This abnormal melanin production is known as melasma