Infundibular hyperkeratosis with subsequent follicular plugging in intertriginous skin areas may result in ductal hypoxia, an HIF-1\documentclass[12pt]{minimal}\usepackage{amsmath}\usepackage{wasysym}\usepackage{amsfonts}\usepackage{amssymb}\usepackage{amsbsy}\usepackage{mathrsfs}\usepackage{upgreek}\setlength{\oddsidemargin}{-69pt}\begin{document}$$\mathrm{a}$$\end{document}a-induced comedogenic mechanism earlier suggested in acne pathogenesis [117, 118]. This evidence concerns the gene HIF1A and Hyperkeratosis.