{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T04:09:25Z","timestamp":1789013365972,"version":"build-2803163510"},"reference-count":63,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2025,10,27]],"date-time":"2025-10-27T00:00:00Z","timestamp":1761523200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,10,27]],"date-time":"2025-10-27T00:00:00Z","timestamp":1761523200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Allergy"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>\n                      Seborrheic dermatitis (\n                      <jats:styled-content style=\"fixed-case\">SD<\/jats:styled-content>\n                      ) is a common skin disease characterized by epithelial barrier breakdown. The epithelial barrier theory (\n                      <jats:styled-content style=\"fixed-case\">EBT<\/jats:styled-content>\n                      ) implicates epithelial barrier disruption in the development of epithelial barrier diseases (\n                      <jats:styled-content style=\"fixed-case\">EBDs<\/jats:styled-content>\n                      ). We hypothesized that\n                      <jats:styled-content style=\"fixed-case\">SD<\/jats:styled-content>\n                      is associated with an increased risk of\n                      <jats:styled-content style=\"fixed-case\">EBDs<\/jats:styled-content>\n                      and investigated the bidirectional association between\n                      <jats:styled-content style=\"fixed-case\">SD<\/jats:styled-content>\n                      and\n                      <jats:styled-content style=\"fixed-case\">EBDs<\/jats:styled-content>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Retrospective cohort study of 5,083,689 patients using a large US administrative claims database from January 1, 2016, to June 30, 2022. The mean (standard deviation) follow\u2010up was 3.25 (1.75) years with a total follow\u2010up of over 16 million person\u2010years. The outcomes were a diagnosis of (i) SD after an EBD and (ii) EBD after SD, analyzed using a multivariable Cox proportional hazards model (hazard ratio [95% confidence interval]).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The risk of SD was increased after EBD diagnosis for multiple diseases, including atopic dermatitis [2.46 (2.40, 2.53)], alopecia areata [3.47 (3.24, 3.71)], contact dermatitis [1.92 (1.88, 1.96)], psoriasis [2.62 (2.54, 2.69)], rosacea [2.84 (2.78, 2.90)], hidradenitis suppurativa [1.79 (1.63, 1.97)], rhinosinusitis [1.34 (1.32, 1.35)], food allergy [1.47 (1.42, 1.54)], celiac disease [1.55 (1.43, 1.68)], ocular allergy [1.55 (1.49, 1.61)], and dry eye [1.54 (1.52, 1.56)]. The risk of EBD after SD diagnosis followed similar trends, with the largest effect estimates being psoriasis [3.52 (3.42, 3.61)], rosacea [2.85 (2.79, 2.92)], and alopecia areata [2.81 (2.61, 3.03)].<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Our results support the EBT as a shared driver of EBD pathogenesis at not only local (e.g., skin) barriers but also at non\u2010local sites, including the respiratory, gastrointestinal, and ocular epithelial barriers.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/all.70112","type":"journal-article","created":{"date-parts":[[2025,10,28]],"date-time":"2025-10-28T13:27:03Z","timestamp":1761658023000},"page":"808-817","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Bidirectional Associations Between Seborrheic Dermatitis and Epithelial Barrier 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