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Despite this complexity, numerous studies have reached conclusions on the intricate process of ASM remodeling, which includes ASM cell proliferation and apoptosis (255, 256), dysregulation Ca2+ homeostasis (257259), excessive production of ECM components like fibronectin and collagen type I that play a role in stimulating the proliferation of human ASM cells (260264), and factors associated with immune cells, airway cells, growth factors, cytokine and inflammatory mediators (263, 265268)

This patient with a history of severe facial eczema is likely chronically applying a topical steroid, which led to her subsequent acneiform eruption