Interestingly, the proportion of very-long-chain ceramides is also decreased in the epidermis of psoriatic lesions [94] and is associated with increased ACOX1 [38] and PPARδ (see above), thus corroborating the key role of the PPARδ pathway in lipid abnormalities in both lesional atopic dermatitis and psoriasis. Here, ACOX1 is linked to psoriasis.