Dermal Adipocytes: From Irrelevance to Metabolic Targets?

Dermal white adipose tissue (dWAT) has received little appreciation in the past as a distinct entity from the better recognized subcutaneous white adipose tissue (sWAT). However, recent work has established dWAT as an important contributor to a multitude of processes, including immune response, wound healing and scarring, hair follicle (HF) growth, and thermoregulation. Unique metabolic contributions have also been attributed to dWAT, at least in part due to its thermic insulation properties and response to cold exposure. Dermal adipocytes can also undergo an adipocyte-myofibroblast transition (AMT), a process that is suspected to have an important role in several pathophysiological processes within the skin. Here, we discuss emerging concepts regarding dWAT physiology and its significance to a variety of cellular processes. Dermal adipocytes are a population of cells that are distinct from subcutaneous adipocytes. Unlike other fat depots, these cells demonstrate high phenotypic flexibility and high turnover rates.Their ability to undergo AMT suggests that they are involved in scarring. Dermal adipocytes exhibit insulating action, and are involved in hormonal skin reactions, as well as HF growth.dWAT can have antimicrobial peptides and, thus, is involved in the pathogenesis of some skin efflorescences. dWAT can be spatially inhomogeneous, thus contributing to the mosaic structure of the skin and being involved in skin hyperpigmentation. dWAT is emerging as a critical metabolic tissue that can also be considered a new target in antiscarring, antiaging, and hair regrowth strategies.