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It also prevents desulfation of dehydroepiandrosterone sulfate, hindering cervical maturation during labor, causing prolonged second stage of labor in carrier women, which can help confirm clinical suspicion.20 Although RXLI is considered a non-syndromic ichthyosis, 30%-40% of patients present with attention deficit hyperactivity disorder, so it is very likely that some steroid metabolized by the STS enzyme plays a role as a neurotransmitter.21 IV and RXLI may have a similar appearance in the more symptomatic IV cases

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