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To me, that would definitely be a case for a Haematologist's opinion, if there's no identifiable cause

It is unclear what triggers the immune system to attack melanocytes in the skin

To diagnose rotator cuff injury, imaging tests may also be helpful, which may include: X-rays A rotator cuff tear may not appear on an X-ray, but this test helps doctors see bone problems like bone spurs or signs of arthritis that could be causing your shoulder pain