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Lolo

My spironolactone and Retin- A micro log

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Hi everyone,

I decided to start this log so that other females with hormonal acne can follow along my progress with spiro (and retin-A micro). There are numerous accutane journals but only a couple spiro logs.

To begin: a little about me and my acne.

I am a 24 year old female and have had mild skin problems since I was about 12. My face was never terrible, just not super consistently clear for the most part. I was never ashamed about my skin because it wasn't that bad (except for those odd big ones that come from underneath and hurt like hell!). I did have bacne throughout a bit of my teenage years though, which wasn't the prettiest, but all in all, it wsan't bad. I have also always had blackheads on my nose, which somewhat bothered me but I dealt with it.

When I started to enter my early twenties and was finishing up my undergrad, I noticed that I was getting sporadic pimples on my face (cheeks) that took a long time to go away. I went to my doctor two years ago and he prescribed some super strong topical cream and minocyclin. the mino did give nice results (though the cream was much too strong), but it turned my teeth green! yuck, i know. but it happens to some. So I went off of it. My doctor said he would give me accutane (I didn't think it was that bad!!!!), but since I was away at grad school, he couldn't monitor me on it so I was never prescribed it. I went to my doctor at the student health, and she put me on birth control pills (Diane 35) and thought they would help my skin and regulate my period. she also put me on differin, which was not bad.

I should mention here that my doctor and derm suspect I have PCOS- which is characterized by acne and irregular menstrual cycles. I actually broke out more with Diane because I got more periods on it and would always have that pre period breakout. Also, Diane wreaked havoc on my emotions. It was really a shitty time for me and I think Diane played a huge role in my mental state. I also gained a bunch of weight (about 15 pds)

I moved at the end of last summer to a new city and had to wait a while before I could get in with a derm at a clinic that is supposed to be good. So I went to some random nurse practioner about my skin, because it was not improving, and she gave me erythomycn and took me off the pill. Emotionally I felt much better and I lost 7 pounds in about 2 weeks. It was crazy. That Diane really didn't agree with me. In any event, the erythomycin was somewhat useful. After about two months, I saw some very moderate improvement, though nothing fantastic. My derm then said to continue using it to give it some time (we can't keep switching all the time, he said). He also told me to talk to my doctor about PCOS symptoms because acne can be caused by this. So I did, and she simply put me on Yasmin (bp with antiandrogens- spiro), without really doing any tests (I have an appointment, with the endocrinologist in July to get something official there). That was a bit frustrating for me- her lack of desire to diagnose me with something that might explain my acne.

I went back to the derm a couple months later and told him it wasn't working. He said since I wasn't responding to the antibiotics or topicals that sprio is my best bet. I asked about accutane (I just want this done with) but he said it wouldn't work for me given the kind of acne I have. You need blood tests before spiro and he said to go when I first got my period. But since I hadn't started the Yasmin yet, my period was quite irregular. so i waited for about a month before I could get my tests. in the interim, my erythomycin prescription finished and my acne all of a sudden came back full force- the dangers of going off antibiotics! I wasn't eating as well as I usually was, so maybe this had something to do with it, but my skin isn't that great now. It actually looks more like your stereotypical case of acne, rather than sporadic zits here and there which was manageable at least.

I started spiro about 2.5 weeks ago and I want to have this journal here for those who are also on this medication (or think they should be) so you can see my progress (fingers crossed) or give me feeback. I really enjoyed reading Shortee's log quite a bit- it was tremendously helpful.

I find that my oil production on my face has diminished noticeably. I used to be greasy come mid-day, but not at all anymore. My hair also is also not as oily. I would have to wash it every day, but earlier this week, I was in a bit of a rush and didn't wash it one day. By the following day, it still looked okay!! In terms of my acne, I feel like it is slowly improving. Ever so slowly becasue I am still getting a few zits here and there but most is just a remainder of what was there before- what developed a month ago. I am a bit thirstier than before, but that is the only real negative side effect. Oh, I might be a bit more tired.

current acne:

On my left cheek, I have many individual zits of varying sizes and kinda red.

on my right cheek, I have a patch of acne (yes a patch- which I have never had before- like bumps). Some of these are whiteheads and some just red bumps. It was super painful when they developed last month.

On my temples, I have a few small zits and a couple bigger red ones, which are fading. My nose still has blackheads covering it (the usual for me though). My forehead is alright- kinda bumpy but not red or anything. My chin is alright as well. I have the remainder of a zit from a couple weeks ago under my nose- just red now.

on my chest- many small zits. they were never there for the last year at least, so don't know where that came from.

I think that sums it up.

my REGIMEN:

morning:

-wash face with neutrogena oil-free acne wash (2% SA)

(- i might add in Benzagel here in a few weeks, but in the past I didn't like the redness it caused)

supper time:

-spiro (100mg)

-Yasmin birth control

bedtime:

-wash face with neutrogena black head remover acne face wash (2% SA)

-retin-A micro gel 0.1%

I have heard doctors recommend not taking spiro at night because it is a dieuretic, but because it makes me kinda more fatigued I decided to take it with my dinner so I will be tired in the evening, rather than all day if i took it in the morning.

I just started retin-A last week. It has been causing some moderate dryness and seems to gradually be drying out that patch of zits on my right cheek because there are less white heads now. I will get a moisturizer though soon with SPF in it. That should help. I will apply that in the morning.

Anyways, that is it for now. If you have any questions please ask. I will try to update every few days!

Lolo

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Week 3

So I have been on spiro for 3 weeks now. It has been pretty good. A definite reduction in my oil production for sure. My hair is soooo much less greasy. HAven't really had any breakout or major pimples- even right before my period, which I got last week. This brings me hope!! The retin-A micro also seems to be working well. It dried out all my zits and white heads. I still have a few bumps and red marks though- I have a feeling these will take longer to get rid of, but apparently r.a.m is supposed to be good for this. I am, however, flaking quite a bit!! my face is very very dry right now and I am moisturizing like crazy. I have but the r.a.m on my cheeks and top of my nose every night and those parts of my face aren't too bad. I know it looks a bit ridiculous, the dry skin and all (so many people saying oh my!! get too much sun?- uh no....) but I want my skin to get used to it asap, so i'll just take it until it hurts too much. No visible changes on my blackheads on my nose though, but I'm being patient. I've only been on the retin-a for a little over a week. I am wondering though if I will have a breakout becasue of it- supposed to be around week 3. I am going back home to see all my family and friends at beginning of July, so I am hoping active acne is no more and that the retin-a works wonders on those red marks- at least to fade them a bit. Would also like my chest to clear up a bit- putting the r.a.m. on it too and it sure is doing a number- hopefully spiro will start to kick in full force soon- apparently takes a while. in any event, i am quite happy with the progress so far. on days where i am down and i know my skin doesn't look amazing, i just say to myself that it is progress and i'm one step closer. and that is what counts. patience is key... alright, update more in a bit!!

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Thanks for keeping this log!!!

Just a quick question: do you find that the 0.1% Retin A-Micro is irritating? I am using a less potent dosage (.04%) and am not having any skin irritation (or improvement for that matter).....I am thinking about using the 0.1% instead. Suggestions?

Thanks again for keeping this log.

uwbadger

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Hi uwbadger,

I feel that the Retin A- Micro 0.1% is doing what it is supposed to- it is stripping the layers off my skin. The constant peeling is more annoying than anything. I have also learned pretty quickly which places on my face can take it every day and which can't. So my cheeks (which is where most of my acne is) aren't too bad and I have applied it there every day. It is moderately dry. My nose (where the blackheads are) isn't dry at all. I had a red mark from ( or a remainder of) a zit under my nose (right at the corner) and had applied there and my face really didn't like that. It did get a bit red and irritated. that only lasted a few days though because i stopped applying it there. so on those sensitive parts, I am more careful about how often i apply (and i am moisturizing there too). but on the other parts where it isn't at all irritating and just a bit dry, I am showing no mercy smile.gif. I just want my skin to get used to this stuff because i know it only starts to work after a while. And as I've said before, I want the active acne to be gone and then want it to work on the red marks. That is why i am happy having the 0.1%- would like the strongest there is to make sure i'm not wasting my time. If you can get your hands on the higher dose, why not? I must be getting better at applying or my skin is getting used to this stuff (or some combo) because actually in the last couple of days, the peeling has really been reduced!! I will start to apply more often to the places that weren't taking it too well and see what happens.

if your skin hasn't been irritated at all it could just mean that your skin adjusted to the medication quickly and it is working. how long have you been on it and how often do you apply? If you don't see results in about 2 months (yeah, i know that is long), then i would ask for a higher dose. if you are concerned now and don't want to wait (as i wouldn't either), I would call the doctor's office and ask them about it- they really know best. my derm's nurse was pretty good at getting back to me with questions and changing my prespcription over the phone when I told her i wanted a different topical.

Hope this helps. Let me know how things go for you!!

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Week 4

So I have now taken spiro for about 4 weeks. I have had less breakouts than previously, that is for sure, with few new zits forming. Having said that, in the last week or so I have had a few emerge. I am hoping that this is because of the retin-A micro (which I have done for 2.5 weeks and people are said to experience an intial breakout around week 3) and not b/c the spiro isn't working (or the dose is too low)... any thoughts out there? I am going to wait and see what happens in the next few weeks. If after 7 weeks on the retin-A I am still breaking out, I am going to talk to the derm and see if my spiro dose has to be higher. I feel less oily than pre-spiro, but not as dry as I had the second week (my hair seems to get oilier faster than that week) so I'm not sure what is going on. Did anyone else experience this? I know that it takes a while for the spiro to really kick in, but if i am still nonstop breaking out at this time, then it is a little worrisome so maybe I will need the derm to up the dose. The blackheads are perhaps improving from the retin-A. The chest has cleared up nicely from that as well. I am hoping that the spiro will help prevent the body acne... I am still dry as before, but not as bad at all. my skin, for the most part, seems to be adjusting. In those places where it is dry, that is mostly where I have the odd zit actually. On my cheeks, where most of the acne was, I feel it is less bumpy and the active acne is drying out. There are minor bumps now, but I am hoping it will get smooth in time. There seems to be less progress with red mark fading these days which is a disappointment b/c that is really what is left on my cheeks. So I am really hoping that the r.a.m will help that in time. I might ask the derm when I call if he recommends or can prescribe something else for that. I am also thinking of trying some peels to help with this. I know that it is mostly time that will help with this, but at least if these other things speed up the process (peeling layers of skin off) that would be good. Okay, I'll update again in a bit. If anyone has anything to share, I would love to hear it. Thanks.

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Thanks so much for getting back to me about the retin-a micro. My derm called me in a new prescription and that seems to be working better (my skin is finally starting to peel and rejuvenate). Unfortunately, the peeling revealed a pimple right along with it, but overall the higher dose seems to be helping. Is your skin still peeling???

The spiro is also helping. Stick with it. I was on 50mg for two weeks and then upped it to 100mg for the two weeks following. At first, my skin cleared up, but then any improvement ceased and my skin went right back to the way it was. I am now on 200mg/day and have been so for the last three weeks. My skin is definitely improving and I am noticing a big difference. Don't get me wrong - it is not totally clear, but it is definitely on its way to being pimple free. If your skin kind of plateaus as mine did, ask to increase your dosage. I guess I'm kind of lucky that my derm just did it for me.....

I sincerely hope your skin clears up and am pulling for you. I totally understand how you feel. Let us know how it goes. Oh, and p.s., I would try using a facial cleanser w/o sa.....using it in conjunction with retin-a can be overly harsh on your skin - too much dryness can be counterproductive....you may see better results w/o the sa. Although, if the peeling has ceased, then nevermind. smile.gif

uwbadger

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Uwbadger,

Thanks for the support! Nice to know people are reading. to answer your question, my skin is midly peeling, but things are definitely better than week 2....

Week 5

So, the last week has been not too bad really, though I had a huge cyst on my left temple (I never get cysts). I am not panicking right away though b/c i figure it could be the retin-A micro- around weeks 3 to 6, it is supposed to be breakout time! I have been on the retin-A for about 3 weeks now, so we will see how the next few weeks go. People who have done well on this have seen good results after week 7 or so, so I will look forward to that. So far, my skin seems to be handling it really well. I also had just a couple minor zits on each cheek which surfaced, but with my red marks there, they really just blended in. My back is clearing up nicely though as is my chest (definitely less peeling there, though a bit red). I am feeling a teeny bit more oily than I have been in the past, but once again I am going to give it a few weeks before I mention something to my derm about the dosage. Actually, his nurse is expected to call me tomorrow so I will mention I am breaking out a teeny bit (the cyst) and that I am a tad more oily (ask if it is from t he ram) and see what he says. I might also ask about the red marks- maybe he'll prescribe something else for that (though doubt it) b/c that is really what is keeping me away from clear skin- right now, I don't really have any active acne (the zits dry up pretty quickly). Besides this, there is not much to report. Oh yeah, I added BP to my morning routine and it is kinda making my face red and a bit more irritated. I can stand it though. HOpefully it will also help active acne while the spiro is kicking in. I am supposed to get my period next week, so it will be interesting to see what happens with my skin then. I will write then.

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WEEK 6

Things are actually looking pretty good for me. I had only one new zit arise all week. It was right on my right cheek and was pretty big and had a head that was white as hell (it was def. ready for poppping, I'm sure people were wondering what was up and were willing to do it). emotionally painful. but i didn't want to pop b/c I don't want anymore red marks. In the end, I did pop b/c it was just a bit too gross to look at. It is healing alright now though (just kinda red and a bump). The retin-A seems to be doing well at speeding up the recovery time of my zits. It also appears to be fading the red marks, which I am pretty happy about. I ordered some neostrata cream with 2% HQ and Kojic acid to lighten the marks (somebody here recommended this). I probably won't use that for a few weeks yet though. I really want things to be smooth on my cheeks before I put on any of that- make sure there is no active acne where I am applying the cream. The r.a.m is also definitely helping smooth things over, so that is great. My chest is pretty clear and less red, though a teeny bit irritated. Maybe a bit too much. I will start laying off with it in a bit. My face is not too dry these days either from the r.a.m which is a good sign. The r.a.m is supposed to cause a breakout for me in the next couple of weeks (it's been four weeks today) so we will see what happens with that and if the spiro will counteract that. I am really happy that I am not as oily as I was before- I don't even have to wash my hair every day now (though I usually do). So things are definitely looking up for me. I hope that the spiro continues to settle in b/c others didn't see good results till months 3 or 4, but so far things are pretty good. (fingers crossed) I am just awaiting the riddance of those red marks though. But one step at a time, right? Till next time...

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WEEK 7

So here's my update... No major breakouts still! This is great. Very few small zits too. Still awaiting that breakout from retin-A micro, but i've been on it for 4 weeks now. after a couple more, there should be little chance of that. My skin isn't peeling at all from it either, which is good. my skin is pretty smooth. the red marks still though bother me a lot. I have added the neostrata gel now into the mix, so that might help lighten then. also, ram is supposed to help. I am also going to start taking vitamin c tablets and msm, which are also supposed to help with this (was reading the red marks boards here). don't want to really put anymore on my face than i have now. There is nothing much else to report right now. Things are pretty good in terms of lack of breaking out and no oil. I skipped my pack of BC for last week though to delay my period till next month (going on camping trips the week I would have had it again), so that might have also helped things. Next time I get it, the spiro should have settled some more. I have an appointment with an endocrinologist (for the PCOS) next month, so am looking forward to that- just to see if we can pinpoint the source of my symptoms. Also, have a derm appointment booked for the beginning of august (hard to get in there) and I also look forward to that- really makes me feel like i'm taking care of myself and doing what I can. Anyways, I will update next week.

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WEEK 7

So here's my update... No major breakouts still! This is great. Very few small zits too.  Still awaiting that breakout from retin-A micro, but i've been on it for 4 weeks now. after a couple more, there should be little chance of that.  My skin isn't peeling at all from it either, which is good. my skin is pretty smooth. the red marks still though bother me a lot. I have added the neostrata gel now into the mix, so that might help lighten then. also, ram is supposed to help. I am also going to start taking vitamin c tablets and msm, which are also supposed to help with this (was reading the red marks boards here). don't want to really put anymore on my face than i have now.  There is nothing much else to report right now.  Things are pretty good in terms of lack of breaking out and no oil. I skipped my pack of BC for last week though to delay my period till next month (going on camping trips the week I would have had it again), so that might have also helped things. Next time I get it, the spiro should have settled some more. I have an appointment with an endocrinologist (for the PCOS) next month, so am looking forward to that- just to see if we can pinpoint the source of my symptoms. Also, have a derm appointment booked for the beginning of august (hard to get in there) and I also look forward to that- really makes me feel like i'm taking care of myself and doing what I can. Anyways, I will update next week.

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Thanks for posting uwbadger and thanks for the warm wishes. It is nice to have someone else where I am- we will work on them red marks together smile.gif

Please keep me posted on how you are making out.

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Week 8

So, not too much new to report here. Same ol, same ol'. no new zits, just red marks. although, i don't know if it is b/c of the neostrata cream (doubt it is the Vitamin C or msm), but my face got extremely dry again for the last four days. It was quite bad. Maybe that and the retin-A was is just too much for me. I am going to keep at it though- I found some good cream to moisturize. My red marks seem to be slowly fading which is nice, but I know this will be a slow process, so I am just bracing myself and focussing on the improvements. And I am done week 6 of r.a.m and they say things start to get noticeable results after week 7 and super good after 12, so I'm hanging in there. I may have avoided that initial breakout b/c of the spiro. I'm not sure. My body seems to be doing well on spiro though, adjusting and all, which is nice b/c I know lots of people here don't see good results for a while. I am actually quite pleased (knock on wood). I have not yet had my period lately (skipped a month) so we will see how it does then. If I take the notion, I may skip next month as well- would love to avoid this pre menstrual flares and wait till my body further absorbs spiro. We will see.. I have to remind myself I am on the pill to regulate the menses, so perhaps not (but my irregularity w/o the pill is one reason why I see no harm in missing either). who knows- a game time decision.

Anyways, I will write again next week!

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thanks for keeping this log. i am also taking spiro. i have been on it for just over three weeks. i go to the derm tomorrow for a check up. can you tell me how that went for you? i am on 50 mg a day, which seems kinda low compared to others on this site. should i request more? i have seen a little improvement (i think) in my oil production, but nothing to write home about! my skin is dry where i have been using tazorac gel, but i still apply powder or blot throughout the day. i am still breaking out, mostly in reoccuring spots, but a few new ones here and there. i am taking mino, too, but i think it isnt working anymore.

your posts are encouraging, though.

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I am happy to hear people are benefiting from this- it is encouraging. Yeah, as you probably read in my inital entry antibiotics wore off for me- at least you are taking something to counteract that though. 50 mg does seem low actually and i think if you are still blotting that may not be the best sign. I would just mention this to your derm tomorrow and say you have been talking to lots of other people on it and they are on higher doses. I did try that with my derm just by calling, but he told me just to come in (2 month wait though). I have not seen my derm since starting spiro. Just went in for some blood tests, which were fine. I think I was still breaking out a bit the first few weeks, but I wasn't oily really... hopefully he/she won't make you wait a couple of months before the dose is changed if it needs to be. If you read shortee's log, she was still breaking out a bit at this point and she thought she needed a higher dose, but she didnt' change it throughout, so that may be possible as well. Good luck to you, keep me posted!

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just an update-took your advice, lolo. he bumped me up to 75mg for a while to see how it goes-take 1 at night and half of 1 in the morning. i am gonna try that for a month, see how i take it. that will make it about 2 months since i started it-bring on the clear skin!!!

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That's great to hear! Is your acne mild? Because that still seems like a low dose... Maybe the derm just isn't familiar with spiro, or wants to see how you do with time, who knows. I am happy the dose has increased. Please post to say how the oil reduction is going in the next little while!

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Week 9

So, things are about the same. I have a smaller zit right above my lip, but besides that the same. No major breakouts. Got one on my back. I am getting my period in a few days, so we will see how my skin deals with this. The retin-A seems to be helping slowly with redmarks. Still doing vitamin-C and msm. Don't really know if it is helping, but figure it can't really hurt. That is about it. I am going out of town for a few weeks and will try to update along the way, but we'll see how that goes...

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Week 12/13

So, the small breakout continued for the next two weeks! They were mostly under my nose, over my lips, and on my chin- places I don't usually get acne. Had about 5 in total- wasn't too impressed because I was going home and o ut of town to see people who haven't seen me in a long time. It was also hard to apply the retin-A every night because I was staying with friends often and felt goofy for having that cream on my face. Right now, Ihave no active acne though and am left with more red marks. These aren't as bad as on my cheeks though.....

I had my appointment with the endocrinologist. She confirmed that I have PCOS and that since I was breaking out, the dose of spiro I am on (100mg) was not enough- submaximal she said. So she raised it to 200mg (one 100 mg in morning, one at night)- I am pretty happy about this. I felt spiro was really good the first two months but then the last few weeks weren't that good. So, we will see how it goes. I haven't been applying the HQ these days, but will start that up again twice a day. I still do retin-A at night, but have not done the benzagel for a while. Oh, I also tried some biore pore strips for the blackheads on my nose- didn't really see any improvement there. I will try again for a few weeks though.

I guess that is it for now, I will update soon.

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this log is very interesting lolo, your case history seems to be just like mine! except i havent found a dermatologist who would bother with me enough to perscribe me any of that stuff you had yet... :/

i'll look around to see if these medicines are available where I live at all....

retin-A and spiro - are they both just perscription drugs?

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Oh, I also tried some biore pore strips for the blackheads on my nose- didn't really see any improvement there. I will try again for a few weeks though.

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Hey, lolo...I was considering of takin Spiro. Cause' I'm kinda getting acne on my neck back and shoulders. Even I get acne on my scalp. I really want my face to be clear. I had a question. Is this treatment is it temporary or you need to take it all the time?

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You pretty much have to take it long term... being re-evaluated for your symptoms every 5 years or so to see if you require it b/c they are not sure of the long term effects of this medication (tumors developed on rats in trials, but not in humans so far). But yeah, it isn't like accutane... this is definitely a long term drug. Have you tried other drugs though? Usually this is given if you do not respond to other drugs (antibiotics and topicals) and if your acne is deemed to be hormonal).

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You pretty much have to take it long term... being re-evaluated for your symptoms every 5 years or so to see if you require it b/c they are not sure of the long term effects of this medication (tumors developed on rats in trials, but not in humans so far). But yeah, it isn't like accutane... this is definitely a long term drug.  Have you tried other drugs though? Usually this is given if you do not respond to other drugs (antibiotics and topicals) and if your acne is deemed to be hormonal).

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