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PubMed Research review emphasizes that post-inflammatory hyperpigmentation risk is significantly elevated in Fitzpatrick IV-VI individuals, highlighting the need for careful consideration when utilizing keratolytic agents

Availability of data and materials Data sharing is not applicable to this study as data management and analysis were only allowed to be conducted in Health and Welfare Data Science Center in Taiwan for data privacy and safety concerns

Preclinical studies relative to carcinogenicity Owing to [Nle 4 , D-Phe 7 ]-MSH being a superpotent synthetic form of a-MSH concerns were present in the minds of the original researchers as to it possibly having the potential to cause melanocytes to turn malignant or to enhance the proliferation of pre-existing melanomas and possibly other skin cancer types