**3.3 The activated phenotype**

Once activated, KCs synthesize additional signaling growth factors and cytokines including TGF-α IL-3, IL-6, IL-8, G-CSF, GM-CSF, and M-CSF [91, 92]. These signaling molecules produced by KCs act as paracrine signal to white blood cells, lymphocytes, fibroblasts, and endothelial cells in dermis. Apart from paracrine, it also acts as an autocrine signal for KCs in epidermis. Numerous cell surface proteins and integrins are also found to act as secondary moiety to activate epidermal KCs [93, 94].
