Medications such as valproic acid, cyclosporine, pivampicillin, and some anti-cancer drugs (e.g., etoposide, vinblastine) can also contribute to carnitine deficiency.[6] Valproic acid therapy may deplete carnitine stores by various mechanisms such as increased urinary excretion as valproylcarnitine, decreased renal tubular reabsorption, and decreased endogenous production
Since the approval of the first GLP-1 RA by the Food and Drug Administration (FDA) in 2005 (exenatide), several GLP-1 receptor agonist drugs have been widely used in clinical practice
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In this case the metastatic melanoma was preceded by a primary cutaneous melanoma in a similar anatomical region