They are caused by more melanin without more melanocytes
Song X, Qu H, Yang Z, Rong J, Cai W, Zhou H
Food and Nutrition Sciences 2(2): 133144 (2011) Vaziri, N
Key features of cancer-related inflammation (CRI) include leukocyte infiltration, cytokine build-up, tissue remodelling, and angiogenesis
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Severe events that have been reported and contributed to discontinuation include IgE-mediated hypersensitivity in 4% of participants in some trials, with one reported anaphylaxis-like reaction [wong (2008) abstract]