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If melanoma is suspected, the dermatologist will remove the abnormal area and a small amount of tissue around it, and send it to a lab

However, the understanding of the stereochemistry of the MSA-DH reaction is crucial for the elucidation of the overall carnitine degradation pathway: L-malate might be directly channeled into the tricarboxylic acid cycle whereas D-malate would require a specific oxidation step that potentially yields the central metabolite oxaloacetate or pyruvate

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This combination may also help address conditions like vitiligo or photosensitivity more effectively, offering both aesthetic and functional improvements