FA2H (fatty acid 2-hydroxylase) is an enzyme that catalyzes the hydroxylation of free fatty acids at the C-2 position to produce 2-hydroxy fatty acids, which serve as essential building blocks for sphingolipids and glycosphingolipids 1. These 2-hydroxylated sphingolipids are particularly abundant in myelin and skin, where they play critical roles in neural tissue function and epidermal barrier formation 1. The enzyme is stereospecific for producing (R)-2-hydroxy fatty acids and is involved in synthesizing galactosphingolipids of the myelin sheath, as well as sphingolipids in plasma membrane rafts that control lipid raft mobility and protein trafficking 1. FA2H expression is significantly downregulated in inflammatory skin conditions including atopic dermatitis, psoriasis, and seborrheic dermatitis, indicating its importance in maintaining skin barrier function 23. Mutations in FA2H cause hereditary spastic paraplegia 35 (HSP35/SPG35), also known as fatty acid hydroxylase-associated neurodegeneration (FAHN), a rare neurodegenerative disorder classified under neurodegeneration with brain iron accumulation (NBIA) 456. The gene's role extends beyond neurological function, as FA2H expression correlates with cancer prognosis and is involved in metabolic vulnerabilities in pancreatic cancer, where it participates in sulfatide biosynthesis pathways 17.