Hydroxy fatty acid (hFA)-sphingolipids play a vital role in cell signaling. hFA-ceramides contribute to the permeability barrier function of the surface epithelium of the skin. Fatty acid 2-hydroxylase (FA2H) catalyzes the synthesis of hFA-ceramides. Impaired function of FA2H causes nervous system disorders leukodystrophy and spastic paraparesis in humans. hFA-ceramides are essential for PM02734, an antitumor drug to exhibit its activity.