It does Not, you either do one or the other, never both.
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TwisterOS Armbian 2.0.3 patch is provided to people who have TwisterOS 2.0.2 already installed and wants to update to latest version without wiping out any data.
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TwisterOS 2.0.3 full image is provided for those who wants a full OS to be flashed into uSD(microsd), eMMC or NVMe and don’t mind about previous contents on storage media because those will be deleted it.