No single mechanism leading to<unk>  exists; rather, a varied multitude of pathologies disrupt normal lipid movement through the cell and cause accumulation. These mechanisms can be separated on whether they ultimately cause an oversupply of lipid which can not be removed quickly enough (i.e., too much in), or whether they cause a failure in lipid breakdown (i.e., not enough used). Failure of lipid metabolism can also lead to the mechanisms which would normally utilise or remove lipids becoming impaired, resulting in the accumulation of unused lipids in the cell. Certain toxins, such as alcohols, carbon tetrachloride, aspirin, and diphtheria toxin, interfere with cellular machinery involved in lipid metabolism. In those with Gaucher's disease, the lysosomes fail to degrade lipids and<unk>  arises from the accumulation of glycolipids. Protein malnutrition, such as that seen in kwashiorkor, results in a lack of precursor apoproteins within the cell, therefore unused lipids which would normally participate in lipoprotein synthesis begin to accumulate. Macrovesicular<unk>  Macrovesicular<unk>  is the more common form of fatty degeneration and may be caused by oversupply of lipids due to obesity, obstructive sleep apnea (OSA), insulin resistance, or alcoholism. Nutrient malnutrition may also cause the mobilisation of fat from adipocytes and create a local oversupply in the liver where lipid metabolism occurs. Excess alcohol over a long period of time can induce<unk> . The breakdown of large amounts of ethanol in alcoholic drinks produces large amounts of chemical energy in the form of NADH, signalling to the cell to inhibit the breakdown of fatty acids (which also produces energy) and simultaneously increase the synthesis of fatty acids. This "false sense of energy" results in more lipid being created than is needed. Microvesicular<unk>  Histopathology of microvesicular<unk> , with foamy hepatocytes (two annotated by arrows), as opposed to macrovesicular<unk>  (insert). Microvesicular<unk>  is characterized by small intracytoplasmic fat vacuoles (liposomes) which accumulate within hepatocytes. Common causes are tetracyclines, acute fatty liver of pregnancy, Reye's syndrome, and hepatitis C.
Steatosis
Dysbiosis
Moist desquamation
Squamous metaplasia
Sclerosis 
Necrobiosis
Scalding
Glandular metaplasia