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Nonsurgical therapies include off-label topical imiquimod and radiation therapy, which are generally second-line but may be preferable in certain instances based on patient comorbidities and/or limited life expectancy, quality of life issues, and/or preference for nonsurgical treatment

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Use carefully in patients with severe liver disease or impaired liver function

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The lipid intake is also lower than a normal condition due to malabsorption and this phenomenon explains lower levels of lipids in sera followed by increased use of ketonic bodies as a more important source of energy in untreated CD patients [78]