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Baby Blue

My derm gave me some great info on cystic acne today

I went to a very highly recommended derm today for the first time. She was terrific; she really sat and explained the skin to me and all the different causes and formulas that treat acne (from aha's-accutane). THough we didn't really talk about accutane...it is out of the question for me at this point.

Anyway, the bad news first...she believes that cystic acne can only be treated from the inside. She believes that topicals are good only once your acne is under control and NOT cystic at all.

Okay the good news...there are tons of antibiotics that will aide in the internal cleanup of cystic acne. THere are even some approved for pregnant women (I am not trying nor preventing another pregnancie-so that was very important to me.

She also gave me topicals to fight the clogged pores and superficial acne (those little boogers are persistant). She gave me an topical antibiotic for the morning under my moisturizer and makeup and then an antibiotic/bp cream for at night to leave on.

She also said that aha (salicylic acid-my personal favorite) is only really good for oil control. THe low active percentages do not do enough to really make a difference in sloughing off dead skin cells. Bummer, huh? Well, she went on to say that Glytone (a soap w glycolid acid) is terrific for taking off dead skin cells so that other meds can be better absorbed. I already used it and was quite impressed with the way my face felt. And it got all my makeup off. It is expensive, but it is a big bottle that will last awhile.

I hope this helps someone. I am looking forward to clear skin soon!

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Wow a derm that actually talks. I didn't know thy could. I though all they did was look at your face and write you a prescription. The longest appointment I ever had took about 5 minutes....

My derm's really into antibiotics for cystic ance, even just non-cystic inflammatory acne....which sucks because I'm not into antibiotics at all.

I just want the 'tane....

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I think if you get the occassional cyst then you can spot treat it effectively with something like QH Mint Julep Masque... But if your face is covered in them then you probably need to get Accutane.

My face gets occassional cysts but the red marks they leave last forever, so my face really is a mess. From first glance it looks like my entire cheeks on both sides are covered in pimples but really it's all those pesky red marks :(

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I think if you get the occassional cyst then you can spot treat it effectively with something like QH Mint Julep Masque... But if your face is covered in them then you probably need to get Accutane.

My face gets occassional cysts but the red marks they leave last forever, so my face really is a mess. From first glance it looks like my entire cheeks on both sides are covered in pimples but really it's all those pesky red marks :(

Me too. I have tons of red marks from my occassional cysts and they will not go away. I haven't started the antibiotics. She told me that if I feel a cyst coming on to take them for one week and it should go away. My only concern is building a tolerance doing it this way, but she assured me that it has never happened.

She told me the reason why she feels that topicals wont work on a cyst is b/c it is already inflamed and there is very little chance that medication will be able to penetrate the pore to provide medication to the pore. Though I have had cooperative cysts; there are some that won't seem to budge.

Where do you get QH Mint Julep? I haven't heard of that.

Oh, and she has great bed side manners! However, I just kept asking questions and she answered and explained everything. I did have to take the initiative to find things out and keep asking questions. She was very thorough in her answers and did not rush at all. But I did my homework before I went in and we were able to really talk about a good treatment plan. I also was not afraid to tell her that there were things (retin a for one) that I would not use and she took that into consideration. She also explained why certain meds probably were not working on me. I can't say enough about her.

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antiobiotics treat existing cysts but the cure and prevention is accutance and no other.

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antiobiotics treat existing cysts but the cure and prevention is accutance and no other.

I don't dispute that accutane is a cure for acne. I think that I even said that the derm told me that at my appointment in the original post.

Accutane is not for everyone and it is not for me! I am of child bearing age and I already have a child born with 'issues' and nephew with major birth defects. My son was born with issues b/c of the tetracycline I took when I was pregnant and did not know it. I will not take that chance and I was giving people information other than accutane.

I will not resort to accutane until I have been 'fixed' or my husband has. Dealing with a special needs child is not worth the risk for me, personally. I thought my life was complicated with just acne; but mix in a child that needs so much care that you barely have time to put on makeup and you are so stressed you break out from it and it doesn't seem worth it really.

Just my thoughts.

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I think if you get the occassional cyst then you can spot treat it effectively with something like QH Mint Julep Masque... But if your face is covered in them then you probably need to get Accutane.

My face gets occassional cysts but the red marks they leave last forever, so my face really is a mess. From first glance it looks like my entire cheeks on both sides are covered in pimples but really it's all those pesky red marks :(

Where do you get QH Mint Julep? I haven't heard of that.

It's pretty common, you should be able to find it at most places near the aisle where theres all those facial cleansers, creams etc. The full name is Queen Helene's Mint Julep Mask. If you can't find it anywhere else you could try a health store. It's really cheap, 3 or 4 bucks gets you a big tube of it that will last awhile. I just use it to spot treat (all over treatment dries my face too much) and it gets rid of blackheads and helps reduce inflammation and clean your pores. It's good stuff.

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I think if you get the occassional cyst then you can spot treat it effectively with something like QH Mint Julep Masque... But if your face is covered in them then you probably need to get Accutane.

My face gets occassional cysts but the red marks they leave last forever, so my face really is a mess. From first glance it looks like my entire cheeks on both sides are covered in pimples but really it's all those pesky red marks :(

I highly doubt that that Mint Julep crap will do anything for a true cystic lesion. I'm not talking about a just a big pustule that hasn't come to a head yet. I mean a full blown cyst. Like a hard, painful lump under the skin that is about 0.5cm in diameter, that will stay there for months if I don't treat it. Even if I glob on duac gel (BP/Clindamycin), it will stay there for at least 6 weeks, and leave behind a nasty scar.....

I know better than to get pregnant on any medication (teratogenic or not)....I've been totally capeable of preventing pregancy for the last 12 years....I doubt an additional 6 months will make a difference.....

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I think if you get the occassional cyst then you can spot treat it effectively with something like QH Mint Julep Masque... But if your face is covered in them then you probably need to get Accutane.

My face gets occassional cysts but the red marks they leave last forever, so my face really is a mess. From first glance it looks like my entire cheeks on both sides are covered in pimples but really it's all those pesky red marks :(

I highly doubt that that Mint Julep crap will do anything for a true cystic lesion. I'm not talking about a just a big pustule that hasn't come to a head yet. I mean a full blown cyst. Like a hard, painful lump under the skin that is about 0.5cm in diameter, that will stay there for months if I don't treat it. Even if I glob on duac gel (BP/Clindamycin), it will stay there for at least 6 weeks, and leave behind a nasty scar.....

I know better than to get pregnant on any medication (teratogenic or not)....I've been totally capeable of preventing pregancy for the last 12 years....I doubt an additional 6 months will make a difference.....

I am not talking about YOU specifically. I am just referring to others who might not want to consider accutane just yet. My FORMER derm told me that using tetracycline would NOT affect my birth control pill. I was a dumb teenager and did not do any research. I turned up pregnant months later. To add to that, I was pretty far into my pregnancy when I figured it out and the damage from the tetracycline was already done.

I just want people to hopefully learn from my mistake. And now that I am educated and older; I too have been successful in preventing pregnancy- as is my husband (who is the father of both of my children). However, 'surprises' happen all the time. My friend just had a vasectomy baby. Another friend, who had her tubaligation grow back is pregnant. And another aquantance is pregnant with twins after her birthcontrol failed due to illness. Maybe we are more fertile in these parts, but I suspect that it is more common in lots of places.

Cysts do suck and I feel your frustration, but the purpose of me starting this thread was to give an alternative to accutane. Your posts seem very angry and I don't understand if they are directed at me or if you are just angry at your situation. However, I feel we are here to support and help eachother; not bring others thoughts and opinions down. Don't get me wrong, you are welcome to your opinion and I appreciate all points of view, but your tone seems to be mean. Am I reading this completely wrong? I hope so!

I think if you get the occassional cyst then you can spot treat it effectively with something like QH Mint Julep Masque... But if your face is covered in them then you probably need to get Accutane.

My face gets occassional cysts but the red marks they leave last forever, so my face really is a mess. From first glance it looks like my entire cheeks on both sides are covered in pimples but really it's all those pesky red marks :(

Where do you get QH Mint Julep? I haven't heard of that.

It's pretty common, you should be able to find it at most places near the aisle where theres all those facial cleansers, creams etc. The full name is Queen Helene's Mint Julep Mask. If you can't find it anywhere else you could try a health store. It's really cheap, 3 or 4 bucks gets you a big tube of it that will last awhile. I just use it to spot treat (all over treatment dries my face too much) and it gets rid of blackheads and helps reduce inflammation and clean your pores. It's good stuff.

Thanks you so much for the information. I am going to Ulta tomorrow to look for it. When you put Queen Helene's - I knew exactly what you were talking about. Much appreciated!!!!

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Congrats on having a Derm that talks to you....My Derm just looks at me and writes prescriptions.

Every now and then he answeres my questions...But their so fast and short I mis them half the time.

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Even for the full blown cysts under the skin, I feel the mask can help them not 'live' as long. Hell, it's better then nothing.

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good job for investigating alternatives to accutane for those who can't/ dont want to take it. people should have lots of options. if you're planning on having another baby in the next few years, your'e right, its not worth it. my derm said that you're totally safe to have kids a month after you go off tane, but definately i would leave it longer than that. surprises happen too. I guess if you're on accutane and having sex, no matter how careful you are and how many forms of birth control you're using, you have to be prepared for the possibility of pregnancy, surprises can happen at any time. if you're on accutane, you have to be prepared for and be ok with either having an abortion or having a child with severe birth defects. both are way worse and more stressful than acne could ever be.

also, props to bably blue for being so vigilant and looking out for any possible future children, doing everything in your power to make sure they come out right. you sound like you're a great mom, so caring.

hahah 'people are more fertile in these parts'..... :lol:

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She also said that aha (salicylic acid-my personal favorite) is only really good for oil control. THe low active percentages do not do enough to really make a difference in sloughing off dead skin cells. Bummer, huh? Well, she went on to say that Glytone (a soap w glycolid acid) is terrific for taking off dead skin cells so that other meds can be better absorbed. I already used it and was quite impressed with the way my face felt. And it got all my makeup off. It is expensive, but it is a big bottle that will last awhile.

I hope this helps someone. I am looking forward to clear skin soon!

why don't you try asking your derm about glymed products?

glymed has a astringent/toner which comes in 5% and 10% salicylic acid, i'm pretty sure either one of those is gonna slough off dead skin cells.

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Since taking B5 all my cystic acne has cleared up entirely. I used to have at least 3 cysts at any given time. Now I only have small moderate spots that kinda come and go and are not a big deal. I definitely believe that cystic acne can't really be treated with topicals. Even Dan says that the only thing that cleared up his cystic acne was accutane. But, I believe B5 is just as effective as Accutane.

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I am not talking about YOU specifically. I am just referring to others who might not want to consider accutane just yet. My FORMER derm told me that using tetracycline would NOT affect my birth control pill. I was a dumb teenager and did not do any research. I turned up pregnant months later. To add to that, I was pretty far into my pregnancy when I figured it out and the damage from the tetracycline was already done.

Don't let these zealous Accutane touting members get to you. If you made a post saying you got one small pimple a year some people on here would be screaming for you to get on Accutane. :rolleyes:

You just do what's best for you.

I'd say the best alternative for treating cystic acne is to ask for a cortisone injection possibly accompanied by antibiotics. It's not a sure bet but it's really worth a shot.

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Found a really interesting article about accutane and birth defects. The bold and underline parts are really important to me....

Under Federal Law, the manufacturer of a drug is required to revise its label to include a warning as soon as there is reasonable evidence of an association of a serious hazard with a drug.

The FDA has required Hoffmann-La Roche to revise their Accutane label numerous times. Because of birth defects and other serious side effects, Accutane has been before the FDA in excess of twenty times. Despite the increased warnings, and measures taken under the direction of the FDA, birth defects remain one of the most troubling side effects of Accutane. Roche's most recent label states, CONTRAINDICATIONS AND WARNINGS: Accutane must not be used by females who are pregnant. Although not every fetus exposed to Accutane has resulted in a deformed child, there is an extremely high risk that a deformed infant can result if pregnancy occurs while taking Accutane in any amount even for short periods of time.Potentially any fetus exposed during pregnancy can be affected. Presently, there are no accurate means of determining, after Accutane exposure, which fetus has been affected and which fetus has not been affected.

Major human fetal abnormalities related to Accutane administration in females have been documented. There is an increased risk of spontaneous abortion.In addition, premature births have been reported.

Documented external abnormalities include: skull abnormality; ear abnormalities (including anotia, micropinna, small or absent external auditory canals); eye abnormalities (including microphthalmia); facial dysmorphia; cleft palate. Documented internal abnormalities include: CNS abnormalities (including cerebral abnormalities, cerebellar malformation, hydrocephalus, microcephaly, cranial nerve deficit); cardiovascular abnormalities; thymus gland abnormality; parathyroid hormone deficiency. In some cases death has occurred with certain of the abnormalities previously noted.

Cases of IQ scores less than 85 with or without obvious CNS abnormalities have also been reported.

Perhaps the birth defects caused by Accutane are the saddest of all the adverse side effects of the drug. Tiny little babies are either killed by the drug, or suffer from horrible defects caused by the drug for as long as they live. They have no choice in the matter and are completely innocent. There have been thousands of elected abortions because the mother became pregnant while taking Accutane. There have also been thousands of spontaneous abortions as a result of the mother taking Accutane while she was pregnant. Either way, it means the death of a baby. :cry:

No child deserves this and FOR ME, my acne is not worth the risk.

Even for the full blown cysts under the skin, I feel the mask can help them not 'live' as long. Hell, it's better then nothing.

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She also said that aha (salicylic acid-my personal favorite) is only really good for oil control. THe low active percentages do not do enough to really make a difference in sloughing off dead skin cells. Bummer, huh? Well, she went on to say that Glytone (a soap w glycolid acid) is terrific for taking off dead skin cells so that other meds can be better absorbed. I already used it and was quite impressed with the way my face felt. And it got all my makeup off. It is expensive, but it is a big bottle that will last awhile.

I hope this helps someone. I am looking forward to clear skin soon!

why don't you try asking your derm about glymed products?

glymed has a astringent/toner which comes in 5% and 10% salicylic acid, i'm pretty sure either one of those is gonna slough off dead skin cells.

Oh, thanks so much! I will have to check into that! Is it a prescription only?

I'm not sure if it's prescription only but you can order it off the internet.

I'm still having troubles finding it in Canada so it might be...

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I think if you get the occassional cyst then you can spot treat it effectively with something like QH Mint Julep Masque... But if your face is covered in them then you probably need to get Accutane.

My face gets occassional cysts but the red marks they leave last forever, so my face really is a mess. From first glance it looks like my entire cheeks on both sides are covered in pimples but really it's all those pesky red marks :(

Me too. I have tons of red marks from my occassional cysts and they will not go away. I haven't started the antibiotics. She told me that if I feel a cyst coming on to take them for one week and it should go away. My only concern is building a tolerance doing it this way, but she assured me that it has never happened.

She told me the reason why she feels that topicals wont work on a cyst is b/c it is already inflamed and there is very little chance that medication will be able to penetrate the pore to provide medication to the pore. Though I have had cooperative cysts; there are some that won't seem to budge.

Where do you get QH Mint Julep? I haven't heard of that.

Oh, and she has great bed side manners! However, I just kept asking questions and she answered and explained everything. I did have to take the initiative to find things out and keep asking questions. She was very thorough in her answers and did not rush at all. But I did my homework before I went in and we were able to really talk about a good treatment plan. I also was not afraid to tell her that there were things (retin a for one) that I would not use and she took that into consideration. She also explained why certain meds probably were not working on me. I can't say enough about her.

thankyou this was helpful I have an apt a week from today for th efirst time with a dermatologist and I'm hoping she can help me. Let me know if the anti biotics have a positive effect on your skin.

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Baby Blue,

I hear you! I specifically waited until I was finished having kids to do Accutane. I could have done it years before, but I was super worried about it doing something permanent, or having residual in my body, that I didn't even do it while I was on birth control, before I wanted kids.

I waited until my family was complete, and my last kid was weaned, and permanent birth control measures were in place.

You're right to be concerned.

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Cysts do suck and I feel your frustration, but the purpose of me starting this thread was to give an alternative to accutane. Your posts seem very angry and I don't understand if they are directed at me or if you are just angry at your situation. However, I feel we are here to support and help eachother; not bring others thoughts and opinions down. Don't get me wrong, you are welcome to your opinion and I appreciate all points of view, but your tone seems to be mean. Am I reading this completely wrong? I hope so!

I am a bit mean....I'm a nasty mean little ball of anger....

All that aside I wasn't directing my anger at you. About the Mint Julep thing....I understand that you're trying to help people but I don't see how a simple absorbant clay mask no that contains no antimicrobials except for preservatives could have any effect whatsoever on a cystic lesion. If you can post a study about it's exact mechanism of action I'd be willing to try it out......

I'm mean because I'm frustrated. I have tried everything except oral antibiotics and Accutane. I'm suppoese to be clear damnit. I put on my retin-a at night and duac in the morning. I take my birth control pills. I eat healthy and drink pleanty of water.....

Yet my face is still an oil slick and and I'm still breaking out. My face did clear up initially, but I was still breaking out monthly. Now It seems as if I'm breaking out constantly regardless of my monthly cycle. I have a bunch of new pustules and some painful neck acne (including two new cysts). My hair hides the neck acne, but I look like I have chicken pox on my face. My boss actually commented on how bad my skin is looking today...."what happend to your skin....you were so clear a few weeks ago????"

I'm not interested in antibiotics, since the reason I get acne to begin with is my excessive sebum production, not the bacteria......the only drug that can shrink the sebaceous glands and decrease sebum production is Accutane.....

Yes I understand that Accutane is highly teterogenic. I agree that it's a tragedy when conception occurs during a course of Accutane. I think Accutane users need to be properly educated to prevent pregancy....

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Since taking B5 all my cystic acne has cleared up entirely. I used to have at least 3 cysts at any given time. Now I only have small moderate spots that kinda come and go and are not a big deal. I definitely believe that cystic acne can't really be treated with topicals. Even Dan says that the only thing that cleared up his cystic acne was accutane. But, I believe B5 is just as effective as Accutane.

IMO, women can't be megadosing B5 or any other kind of vitamin if there's a chance of pregnancy. It isn't responsible.

About the Mint Julep thing....I understand that you're trying to help people but I don't see how a simple absorbant clay mask no that contains no antimicrobials except for preservatives could have any effect whatsoever on a cystic lesion. If you can post a study about it's exact mechanism of action I'd be willing to try it out......

It has sulfur in it too. It's a decent spot treatment, though I don't know if it would work on honest-to-god deep cysts ... I think people on this board have very different ideas of what constitutes a cyst ...

Baby Blue, if you try this stuff, DON'T put it all over your whole face. It's horribly dehydrating.

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Since taking B5 all my cystic acne has cleared up entirely. I used to have at least 3 cysts at any given time. Now I only have small moderate spots that kinda come and go and are not a big deal. I definitely believe that cystic acne can't really be treated with topicals. Even Dan says that the only thing that cleared up his cystic acne was accutane. But, I believe B5 is just as effective as Accutane.

IMO, women can't be megadosing B5 or any other kind of vitamin if there's a chance of pregnancy. It isn't responsible.

About the Mint Julep thing....I understand that you're trying to help people but I don't see how a simple absorbant clay mask no that contains no antimicrobials except for preservatives could have any effect whatsoever on a cystic lesion. If you can post a study about it's exact mechanism of action I'd be willing to try it out......

It has sulfur in it too. It's a decent spot treatment, though I don't know if it would work on honest-to-god deep cysts ... I think people on this board have very different ideas of what constitutes a cyst ...

Baby Blue, if you try this stuff, DON'T put it all over your whole face. It's horribly dehydrating.

Is the sulfur claimed as a drug active???? I doubt it's effective at a low level. If it was meant to actually kill bacteria than it would be labled as a cosmetic drug......The level I think is 6% for it to be claimed as an anti-bacterial agent.....by the ingredient labeling I'm guessing it's only in theire at 1% or less.......

I agree than many people confuse pustules that haven't come to heads yet with a cysts. A cyst has no head, or if it happens to "ripen" it has multiple (like 3-5 or more) "heads" that are small pus sacs......neat huh???

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The level I think is 6% for it to be claimed as an anti-bacterial agent.....by the ingredient labeling I'm guessing it's only in theire at 1% or less.......

I'm sure you're right ... I just remembered checking the ingredient list once and seeing sulfur.

I agree than many people confuse pustules that haven't come to heads yet with a cysts. I cyst has no head, or if it happens to "ripen" it has multiple (like 3-5 or more) "heads" that are small pus sacs......neat huh???

Thanks for sharing. :)

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IMO, women can't be megadosing B5 or any other kind of vitamin if there's a chance of pregnancy. It isn't responsible.

I agree.

I think people on this board have very different ideas of what constitutes a cyst ...

Yes and not just this on board. My derm told me to refer my deep painful pimples as cysts but they are really just nasy pustules. I think it got me in for injections faster. I think I had one truly cystic zit in my life and even with oral antibiotics and shot and topicals, that thing stayed on my forehead for weeks.

BTW, I'm also planning to try getting pregnant this summer and have discussed this with my derm. She says nothing is proven to be safe (we can't go around doing controlled studies on pregnant women re: possible birth defects) and her position is that since acne doesn't pose health threat to me, she'd rather see me off all oral and topical antibiotics. Other topicals are also out of the picture. Her plan is to first get me completely clear (and I am now; I was too lazy to stay on the meds before) then start take me off one medication at the time to see what happens. I'm not looking forward to dealing with breakouts but I feel most comfortable with this approach.

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Baby Blue & Candy-

I am trying to get pregnant sometime this summer so I really really appreciate the information you have posted!!! I am weaning myself off doryx right now and I am breaking out like no other (cysts everywhere)! Baby blue- what issues did you have from tetracycline with your baby (PM me PLEASE!) I read that doryx (in the tetracycline class) is thought to be safe in the first trimester but they discourage the use becayse there are no studies that prove safety beyond a shadow of a doubtit. After the first trimester, it effects bone/tooth development. What antibiotics did she say are OK for pregnant women, are you having any success so far? Erthromycin is supposed to be safe because it does not pass anywhere near the placenta/baby. I researched this for 5 hours one day because my cysts are out of control and I needed some answers. I am considering doing levulan treatments if I can squeeze in some home days in the next 2 months, but I still have to work and that requires a lot of time off. We won't really start trying for the baby until probably May. Thanks in advace for your replies!!!!

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