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Hutchinson sign, which was first described in 1886 by Jonathan Hutchinson, is defined as a periungual, brownish-black area of pigmentation that originates from the nail bed and nail matrix and subsequently involves the surrounding skin

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In particular, fatigue generates a series of inflammatory responses in the body, changing the levels of IL-1, IL-2, IL-6, and TNF-, which are the key pro-inflammatory cytokines involved in the initiation of the anti-inflammatory response to injury