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Yeast of the genus\n                    <jats:italic>Malassezia<\/jats:italic>\n                    has long been regarded as a main predisposing factor, even though causal relationship has not been firmly established. Additional predisposing factors have been described, including sebaceous activity, host immunity (especially\n                    <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content>\n                    infection), epidermal barrier integrity, skin microbiota, endocrine and neurologic factors, and environmental influences. Genetic studies in humans and mouse models\u2014with particularly interesting insights from examining the\n                    <jats:italic>Mpzl3<\/jats:italic>\n                    knockout mice and their\n                    <jats:styled-content style=\"fixed-case\">SD<\/jats:styled-content>\n                    \u2010like skin phenotype, and patients carrying a\n                    <jats:italic>\n                      <jats:styled-content style=\"fixed-case\">ZNF<\/jats:styled-content>\n                      750\n                    <\/jats:italic>\n                    mutation\u2014highlight defects in host immunity, epidermal barrier and sebaceous activity. After synthesizing key evidence from the literature, we propose that intrinsic host factors, such as changes in the amount or composition of sebum and\/or defective epidermal barrier, rather than\n                    <jats:italic>Malassezia<\/jats:italic>\n                    , may form the basis of\n                    <jats:styled-content style=\"fixed-case\">SD<\/jats:styled-content>\n                    pathobiology. We argue that these intrinsic changes provide favourable conditions for the commensal\n                    <jats:italic>Malassezia<\/jats:italic>\n                    to over\u2010colonize and elicit host inflammatory response. Aberrant host immune activity or failure to clear skin microbes may bypass the initial epidermal or sebaceous abnormalities. We delineate specific future clinical investigations, complemented by studies in suitable\n                    <jats:styled-content style=\"fixed-case\">SD<\/jats:styled-content>\n                    animal models, that dissect the roles of different epidermal compartments and immune components as well as their crosstalk and interactions with the skin microbiota during the process of\n                    <jats:styled-content style=\"fixed-case\">SD<\/jats:styled-content>\n                    . This research perspective beyond the conventional\n                    <jats:italic>Malassezia<\/jats:italic>\n                    \u2010centric view of\n                    <jats:styled-content style=\"fixed-case\">SD<\/jats:styled-content>\n                    pathogenesis is expected to enable the development of better therapeutic interventions for the management of recurrent\n                    <jats:styled-content style=\"fixed-case\">SD<\/jats:styled-content>\n                    .\n                  <\/jats:p>","DOI":"10.1111\/exd.14006","type":"journal-article","created":{"date-parts":[[2019,7,16]],"date-time":"2019-07-16T13:03:10Z","timestamp":1563282190000},"page":"991-1001","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":144,"title":["Seborrheic dermatitis\u2014Looking beyond\n                    <i>Malassezia<\/i>"],"prefix":"10.1111","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6307-7986","authenticated-orcid":false,"given":"Tongyu C.","family":"Wikramanayake","sequence":"first","affiliation":[{"name":"Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery University of Miami Miller School of Medicine Miami FL USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luis J.","family":"Borda","sequence":"additional","affiliation":[{"name":"Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery University of Miami Miller School of Medicine Miami FL USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mariya","family":"Miteva","sequence":"additional","affiliation":[{"name":"Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery University of Miami Miller School of Medicine Miami FL USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ralf","family":"Paus","sequence":"additional","affiliation":[{"name":"Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery University of Miami Miller School of Medicine Miami FL USA"},{"name":"Centre for Dermatology Research University of Manchester Manchester UK"},{"name":"NIHR Biomedical Research Centre Manchester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,8,19]]},"reference":[{"key":"e_1_2_12_2_1","first-page":"428","volume-title":"Fitzpatrick's Dermatology I","author":"Suh D. 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