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Description
The mechanism is informational, not structural

Endogenous biosynthesis Humans can synthesize L-carnitine from the amino acids lysine and methionine in a multi-step process occurring across several cell compartments (cytosol, lysosomes, and mitochondria) (reviewed in 6)

A pathologist will analyze the tissue and confirm whether it contains noncaseating granulomas
Potential etiologies include ultraviolet radiation [45], human papillomavirus infections, repeated trauma, chronic infections, human immunodeficiency virus, and epidermal dysplasia [24, 27, 45]