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[DOI] [PubMed] [Google Scholar] 479

Many patients exhibit: Heat sensitivity Stress-triggered flushing Rapid redness changes Burning sensations This suggests dysregulation involving: Mast cells Nervous system signaling Blood vessel reactivity Stress, poor sleep, and cortisol dysregulation may amplify these pathways

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Patients with unstable cardiovascular disease, poorly controlled hypertension, or significant hypotension may require additional monitoring or alternative therapies
