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Teixeira MM, Theodoro RC, Carvalho MJ, Fernandes L, Paes HC, et al

The phenomenon of skin bleaching is a global problem with rates as high as 77% in countries like Nigeria, according to a WHO estimate 1

Currently, generally recognized is the multiple hit theory, which uses insulin resistance (IR) and obesity the first hit to increase free fatty acids (FFAs) and make the liver more susceptible to hepatotoxic injury

Informed consent was obtained from all participants in the study and the study was approved by the Scientific Ethical Committee of Rennes Hospital in France (Avis n 22.185)