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In rare circumstances, your doctor may take a sample of the affected skin and send it for a skin biopsy

Additionally, Protein kinase C (PKC) pathway activation can induce insulin receptor substrate 1 (IRS-1) phosphorylation, inhibiting insulin signaling through downstream effectors such as Akt, phosphoinositide 3-kinase (PI3K), and glucose transporter 4 (GLUT-4) (Ritter et al., 2015