Frontiers in allergy最新文献

{"title":"Severe recurrent anaphylaxis: investigating underlying mechanisms beyond IgE-mediated allergy - a case report.","authors":"Agnieszka Gawlewicz-Mroczka, Ewelina Gacek, Natalia Zamorska, Krzysztof Sładek","doi":"10.3389/falgy.2026.1866446","DOIUrl":"10.3389/falgy.2026.1866446","url":null,"abstract":"<p><p>Anaphylaxis is a sudden, life-threatening, and generalized allergic reaction that develops within minutes to hours following exposure to an allergen. Cutaneous, respiratory, and cardiovascular symptoms may occur in various combinations, and the severity of the reaction can vary, potentially leading to anaphylactic reactions, which, if untreated with epinephrine, may be fatal. Although anaphylaxis is most commonly caused by allergic mechanisms, cofactors and comorbidities can contribute to increased severity. We present the case of a 34-year-old man who repeatedly experienced severe anaphylactic reactions after consuming products containing defensins. Comprehensive diagnostic evaluation confirmed an IgE-dependent allergic reaction to inhalant defensins. Additionally, histamine intolerance was suspected, and suspicion of systemic mastocytosis (SM) was raised. This study aims to describe the diagnostic process and highlight the challenges in differentiating clinical symptoms arising from overlapping pathophysiological mechanisms in these conditions.</p>","PeriodicalId":73062,"journal":{"name":"Frontiers in allergy","volume":"7 ","pages":"1866446"},"PeriodicalIF":3.4,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13369475/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148457811","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advances in clinical examination techniques for allergic rhinitis: a review from traditional testing to precision diagnosis.","authors":"Xinyan Liu, Yongtai Wang, Hexiao Tian, Dongdong Zhu, Cuida Meng","doi":"10.3389/falgy.2026.1851667","DOIUrl":"10.3389/falgy.2026.1851667","url":null,"abstract":"<p><p>Allergic rhinitis (AR) is an IgE-mediated, non-infectious inflammatory disorder of the nasal mucosa, and accurate diagnosis is important for individualized treatment. Over the past decade, diagnostic strategies for AR have evolved substantially from conventional methods, such as skin prick testing and serum-specific IgE testing, toward advanced approaches, including molecular allergen diagnostics, biomarker profiling, functional imaging, and artificial intelligence-assisted assessment. This review provides a systematic overview of these developments by summarizing the underlying principles, clinical utility, strengths, and limitations of each method. It also discusses the integration of multi-omics and digital health technologies, which have the potential to support truly precise and individualized diagnostics. By critically reviewing current strategies and future research directions, this article aims to help clinicians optimize patient management and promote further development in the field of AR diagnostics.</p>","PeriodicalId":73062,"journal":{"name":"Frontiers in allergy","volume":"7 ","pages":"1851667"},"PeriodicalIF":3.4,"publicationDate":"2026-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13365042/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148450884","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Routine lipid profiles in allergic disease: a mini review.","authors":"Yu Kyoung Hwang","doi":"10.3389/falgy.2026.1876509","DOIUrl":"10.3389/falgy.2026.1876509","url":null,"abstract":"<p><p>Allergic diseases are traditionally interpreted through epithelial barrier dysfunction, type 2 immune activation, and downstream inflammatory mediators, whereas routine serum lipid measures have usually been considered markers of cardiometabolic risk. However, emerging clinical and mechanistic evidence suggests that high-density lipoprotein (HDL), low-density lipoprotein (LDL), and triglycerides (TG) may provide additional information about systemic inflammatory and metabolic contexts in allergic diseases. This review synthesizes current evidence on routine lipid profiles across asthma, atopic dermatitis, and allergic rhinitis, with emphasis on their clinical associations, disease-specific differences, and potential immune mechanisms. Asthma currently provides the strongest case for clinical relevance, with lipid abnormalities linked to disease burden, metabolic complexity, and heterogeneous clinical outcomes. In atopic dermatitis, circulating lipid measures appear less central than epidermal barrier lipid abnormalities, although they may still reflect selected metabolic or cardiovascular risk contexts. In allergic rhinitis, clinical associations remain inconsistent, but mechanistic studies suggest that lipoprotein function, particularly HDL-related regulation of eosinophils, antigen-presenting cells, and type 2 innate lymphoid cells, may be biologically relevant. Overall, this review presents routine lipid profiles as accessible contextual markers that may help connect systemic metabolism with allergic immune regulation, refine clinical stratification, and generate hypotheses about lipid-immune crosstalk. Future studies integrating routine lipid panels with functional lipoprotein assays, tissue-level immunology, and longitudinal outcome data are needed to determine whether these measures can become useful tools in allergic disease management.</p>","PeriodicalId":73062,"journal":{"name":"Frontiers in allergy","volume":"7 ","pages":"1876509"},"PeriodicalIF":3.4,"publicationDate":"2026-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13357908/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148438964","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of vitamin D levels and vitamin D supplementation on allergic diseases: an umbrella review.","authors":"Yuxin Hou, Qitong Zhang, Xianpeng Xu, Guangran Zhao","doi":"10.3389/falgy.2026.1841244","DOIUrl":"10.3389/falgy.2026.1841244","url":null,"abstract":"<p><strong>Background: </strong>The association between vitamin D levels/supplementation and the risk of allergic diseases has been extensively studied. However, the strength and consistency of the existing evidence remain unclear, and most reviews have focused on single diseases. This umbrella review aims to systematically evaluate the current meta-analytic evidence on the associations between vitamin D and allergic diseases, in order to establish a hierarchy of evidence and identify research gaps.</p><p><strong>Methods: </strong>PubMed, Embase, Cochrane Library, and Web of Science were systematically searched from inception to October 21, 2025. Summary effect estimates, 95% confidence intervals, I² statistic, 95% prediction intervals, small study effects, <i>p</i>-value of the largest study, and excess significance bias were recalculated. The methodological quality of included studies was appraised using AMSTAR 2 (A Measurement Tool to Assess Systematic Reviews 2).</p><p><strong>Results: </strong>A total of 14 eligible articles were included, yielding 16 associations (total population: 66,387). The credibility of evidence assessment revealed the following: the association between serum 25(OH)D levels and urticaria was graded as highly suggestive evidence (MD -9.35, -12.27 to -6.44, class II); the associations between serum 25(OH)D levels and allergic rhinitis and between vitamin D supplementation and urticaria were graded as suggestive evidence (SMD -1.29, -1.92 to -0.65, class III). Vitamin D supplementation significantly alleviated symptoms in allergic rhinitis (SMD -2.25, -3.05 to -1.43, class Ⅳ), reduced disease severity in atopic dermatitis (SMD -0.41, -0.65 to -0.17, class Ⅳ), and decreased clinical scores in urticaria (SMD -3.63, -5.72 to -1.54, class III). However, no significant effect was observed for vitamin D supplementation on asthma or food allergy. Prenatal vitamin D supplementation showed no significant preventive effect on the risk of offspring allergic rhinitis, atopic dermatitis, or asthma.</p><p><strong>Conclusions: </strong>Lower vitamin D levels are consistently associated with several allergic diseases. The available evidence suggests that vitamin D supplementation demonstrates beneficial effects on symptom improvement for specific diseases (allergic rhinitis, atopic dermatitis, urticaria), but its efficacy is disease-specific. Future research requires greater standardization and precision to clarify the exact role and clinical utility of vitamin D in the prevention and management of different allergic diseases.</p><p><strong>Systematic review registration: </strong>https://www.crd.york.ac.uk/prospero/.</p>","PeriodicalId":73062,"journal":{"name":"Frontiers in allergy","volume":"7 ","pages":"1841244"},"PeriodicalIF":3.4,"publicationDate":"2026-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13357912/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148439214","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tezepelumab attenuates exertional symptom burden in severe asthma: insights from a real-world cohort.","authors":"Slagjana Stoshikj, Katharina Marth, Daniela Boryshchuk, Robin Ristl, Andreas Renner, Christina Bal, Karin Patocka, Wolfgang Pohl, Karin Vonbank, Marco Idzko","doi":"10.3389/falgy.2026.1849268","DOIUrl":"10.3389/falgy.2026.1849268","url":null,"abstract":"<p><strong>Background: </strong>Exertional symptom burden is an important yet insufficiently characterised component of morbidity in severe asthma. Tezepelumab, a monoclonal antibody targeting thymic stromal lymphopoietin (TSLP), reduces exacerbations and improves asthma control across phenotypes, but its effects on patient-reported exertional symptoms and physical activity limitation remain unclear.</p><p><strong>Methods: </strong>We conducted a retrospective study in 24 adults with severe asthma initiating tezepelumab per GINA criteria. The 6-item Asthma Control Questionnaire (ACQ-6), Asthma Control Test (ACT), and mini-Asthma Quality of Life Questionnaire (miniAQLQ) were administered at baseline and at 3 (<i>n</i> = 24), 6 (<i>n</i> = 20), and 12 months (<i>n</i> = 16). Pre-specified exercise-related items were analysed alongside total scores using the Wilcoxon signed-rank test.</p><p><strong>Results: </strong>At baseline, patients had poorly controlled asthma (median ACQ-6 3.50/6, ACT 11/25, miniAQLQ 3.53/6) and moderate-to-severe airflow limitation (median FEV₁ 57% predicted). Total scores improved progressively over 12 months, with changes at months 6 and 12 exceeding the respective minimal clinically important differences. Exertion-related items showed consistent improvements at least as pronounced as total score changes. The largest improvements were in strenuous activity limitation (miniAQLQ Q12: median change +2.0, <i>p</i> = 0.006) and overall activity limitation (ACQ-6 Q3: median change -2.5, <i>p</i> = 0.008).</p><p><strong>Conclusion: </strong>In severe asthma, Tezepelumab is associated with progressive attenuation of exertional symptoms over 12 months of real-world treatment. These associative findings are consistent with mechanistic data and support further prospective studies.</p>","PeriodicalId":73062,"journal":{"name":"Frontiers in allergy","volume":"7 ","pages":"1849268"},"PeriodicalIF":3.4,"publicationDate":"2026-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13357412/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148438937","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Point-of-care smell testing for evaluation of olfactory function: a narrative review of clinical utility.","authors":"Akshita Joshi, Haley Ogbemudia, Cailin Cruess, Alicia A Livinski, Rosangele Hall, Ethan Roback, Jasmine Jain, Aarti Sharma, Prestina Smith-Davidson, Mei Xu, Valerie Asher, Paule V Joseph, Joshua M Levy","doi":"10.3389/falgy.2026.1882615","DOIUrl":"10.3389/falgy.2026.1882615","url":null,"abstract":"<p><strong>Importance: </strong>Olfactory dysfunction (OD) is increasingly recognized as a clinically relevant biomarker for a wide range of health conditions, including neurodegenerative diseases, respiratory infections such as COVID-19, psychiatric disorders, and age-related sensory decline. Despite its diagnostic value, olfactory testing remains underutilized in routine clinical care due to challenges related to test accessibility, cultural adaptability, cost and practical implementation.</p><p><strong>Observations: </strong>This narrative review provides a clinically focused synthesis of olfactory tests suitable for point-of-care (POC), focusing on their diagnostic accuracy, administration methods, user-friendliness, and applicability across diverse clinical populations. Commonly used tests such as the University of Pennsylvania Smell Identification Test (UPSIT®) and Sniffin' Sticks® are discussed alongside emerging rapid screening tools, pediatric assessments, and culturally adapted tests. Attention is given to distinguishing screening tools from comprehensive diagnostic batteries and to the role of point-of-care (POC) testing in primary care, neurology, and otorhinolaryngology settings. Practical considerations including assessment time, workflow feasibility, and clinical decision pathways are also examined. This review emphasizes the translation of available psychophysical tests into a practical POC framework for real-world clinical use.</p><p><strong>Conclusions and relevance: </strong>Available olfactory tests vary substantially in diagnostic accuracy, feasibility, and clinical applicability, highlighting the importance of selecting tests based on clinical indication and practice setting. Brief POC tests are best positioned as screening tools, while comprehensive batteries remain necessary when diagnostic precision is required. The main contribution of this review is a clinically oriented framework that distinguishes screening from diagnostic testing and aligns test selection with adult and pediatric clinical scenarios, workflow constraints, and referral needs. A tiered clinical approach using rapid screening followed by targeted comprehensive testing may represent the most practical, cost and time effective strategy for integrating olfactory assessment into routine care. Broader implementation of clinically feasible olfactory testing may improve early disease detection, support clinical decision making, and enhance patient care across conditions associated with OD.</p>","PeriodicalId":73062,"journal":{"name":"Frontiers in allergy","volume":"7 ","pages":"1882615"},"PeriodicalIF":3.4,"publicationDate":"2026-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13349926/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148426908","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Situation report: reactions to mammalian amniotic fluid and blood among veterinarians.","authors":"Maureen Milon, Benjamin Savoye, Cécile Morice, Yann Ollivier, Brigitte Le Mauff, François Ledoyen, Julien Serrier","doi":"10.3389/falgy.2026.1873093","DOIUrl":"10.3389/falgy.2026.1873093","url":null,"abstract":"<p><strong>Background: </strong>Reactions to animal biological fluids are poorly described in veterinary occupational health, despite exposures during obstetrical and surgical procedures. This study aimed to characterize the clinical features and risk determinants of reactions to mammalian amniotic fluid (AF) and blood in veterinarians.</p><p><strong>Methods: </strong>A questionnaire was distributed to veterinarians practicing in France and Belgium. Data collected included demographics, allergic history, types of animal exposure, clinical features of reactions, time of onset of symptoms, use of protective equipment.</p><p><strong>Results: </strong>Among 317 respondents, 46% reported reactions to AF and 16% to blood. These reactions were predominantly cutaneous and often delayed, contrasting with the more frequent respiratory symptoms reported after common animal contact. Most cases were linked to bovine exposure and occurred early in obstetrical practice. A strong association was observed between the onset of parturitions practice and first symptoms. Increased number of parturitions and absence of protective measures were associated with higher risk.</p><p><strong>Conclusions: </strong>Reactions to mammalian AF and blood represent a distinct occupational entity in veterinary medicine. The symptoms could be suggestive of protein contact dermatitis. Early exposure and insufficient protection may contribute to their development, highlighting the need for preventive strategies and validated diagnostic tools.</p>","PeriodicalId":73062,"journal":{"name":"Frontiers in allergy","volume":"7 ","pages":"1873093"},"PeriodicalIF":3.4,"publicationDate":"2026-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13349834/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148426977","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Occult recurrence of sinonasal inverted papilloma masked by a mucocele: a case report.","authors":"Ronghua Wu, Jiangmiao Li, Yiwen Liang, Liang Tang, Yu Zou, Nan Yang, Min Li, Jian Li","doi":"10.3389/falgy.2026.1877618","DOIUrl":"10.3389/falgy.2026.1877618","url":null,"abstract":"<p><strong>Background: </strong>Sinonasal inverted papilloma (SNIP) is a benign but locally aggressive tumor. Although recurrence typically presents as a solid mass on imaging, atypical manifestations may pose diagnostic difficulties.</p><p><strong>Case presentation: </strong>A 56-year-old man with previous SNIP resection presented with progressive left orbital pain. Computed tomography (CT) and magnetic resonance imaging (MRI) showed an expansile cystic lesion in the left frontal and ethmoid sinuses, initially interpreted as a mucocele. Intraoperatively, a papillomatous lesion was identified at the frontal sinus ostium. Pathology confirmed SNIP with focal mild cytologic atypia.</p><p><strong>Conclusion: </strong>SNIP recurrence can be masked by a secondary mucocele, leading to negative preoperative tests. Our experience suggests that in high-risk patients, thin-section MRI (≤1-2 mm) may improves detection, and surgical exploration with cyst wall biopsy should be performed when clinical suspicion remains high.</p>","PeriodicalId":73062,"journal":{"name":"Frontiers in allergy","volume":"7 ","pages":"1877618"},"PeriodicalIF":3.4,"publicationDate":"2026-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13349747/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148426967","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Panallergen sensitization in children with eosinophilic esophagitis: a pilot study.","authors":"Raffaella De Santis, Valentina Silvera, Cristina Ferrigno, Laura Gianolio, Cecilia Mantegazza, Cristina Cocuccio, Lorenzo Norsa, Miriam Acunzo, Gian Vincenzo Zuccotti, Elena Pozzi, Enza D'Auria","doi":"10.3389/falgy.2026.1806340","DOIUrl":"10.3389/falgy.2026.1806340","url":null,"abstract":"<p><strong>Background: </strong>Eosinophilic esophagitis (EoE) is a chronic, immune-mediated disorder associated with atopic comorbidities and may be considered a late manifestation of the atopic march. This study aimed to evaluate the prevalence of atopic comorbidities, sensitization to food allergens and panallergens in pediatric EoE patients, and to explore the potential association between panallergen sensitization and response to treatment.</p><p><strong>Methods: </strong>We conducted a single-center observational study on pediatric EoE patients, followed at Vittore Buzzi Children's Hospital in Milan. Clinical, endoscopic, and histological data, together with sensitization profiles to food allergens and panallergens [profilins, PR-10 proteins, and lipid transfer proteins (LTPs)] were collected. Patients were classified into two groups according to their response to PPI therapy. <i>Group 1</i> included patients who maintained histological remission on PPIs. <i>Group 2</i> included patients who either failed to respond to PPI induction therapy or relapsed on maintenance dosing, thus requiring a therapeutic switch.</p><p><strong>Results: </strong>Twenty-four patients (median age 11.5 years, IQR 9-13; 23 males) were enrolled. 79% (19/24) had a family history of atopy and 19/24 (79%) had allergic comorbidities. Sensitization to food allergens was observed in 17/24 (71%); panallergen sensitization was detected in 15/24 patients (63%). <i>Group 2</i> showed a significantly higher prevalence of panallergen sensitization (78% vs. 17%, <i>p</i> = 0.015) and atopic dermatitis (56% vs. 17%, <i>p</i> < 0.05) compared to <i>Group 1</i>. Sensitization to profilins and LTPs was associated with lack of PPI response.</p><p><strong>Conclusions: </strong>This study is the first to address panallergen sensitization in a pediatric cohort of EoE patients. Our findings suggest that panallergen sensitization might be associated with response to PPI. However, these preliminary findings require confirmation in larger, powered studies.</p>","PeriodicalId":73062,"journal":{"name":"Frontiers in allergy","volume":"7 ","pages":"1806340"},"PeriodicalIF":3.4,"publicationDate":"2026-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13342198/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148413889","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Contact sensitization to hair care allergens in scalp seborrheic dermatitis: associations with disease severity and microbiota profiles.","authors":"Can Cui, Yutong Xie, Jinghan Yuan, Jianyi Ni, Youxue Wang, Aihua Wei, Rong Tao","doi":"10.3389/falgy.2026.1862176","DOIUrl":"10.3389/falgy.2026.1862176","url":null,"abstract":"<p><strong>Background: </strong>Scalp seborrheic dermatitis (SSD) is a chronic inflammatory skin disorder characterized by impaired barrier function and intolerance to topical products. However, the relationship between contact sensitization and scalp microbiota in SSD remains unclear.</p><p><strong>Methods: </strong>A total of 63 participants underwent patch testing with 62 allergens and were grouped according to the presence or absence of scalp involvement. Clinical assessments included symptom severity, transepidermal water loss, and stratum corneum hydration. Bacterial 16S rRNA V3-V4 sequencing and fungal ITS1 sequencing were performed in a subset of 36 patients with SSD to evaluate associations between allergen sensitization and scalp microbiota.</p><p><strong>Results: </strong>The most frequent sensitizers in patients with SSD were cobalt chloride, cetrimonium bromide, p-methylaminophenol, nickel sulfate, decyl glucoside, and minoxidil, although overall sensitization rates did not differ significantly between SSD and control groups. Specific allergens were associated with age, sex, disease duration, and disease severity. Increased transepidermal water loss was correlated with fragrance and preservative allergens. Minoxidil sensitization was negatively associated with <i>Malassezia</i>, whereas several fragrance and preservative allergens were correlated with <i>Candida</i>, <i>Staphylococcus</i>, and <i>Corynebacterium</i>.</p><p><strong>Conclusion: </strong>Patients with SSD showed distinct sensitization patterns associated with clinical characteristics, barrier dysfunction, and scalp microbiota alterations. These findings suggest that patch test reactivity in SSD should be interpreted in the broader context of allergen exposure, skin barrier status, and microbial imbalance.</p>","PeriodicalId":73062,"journal":{"name":"Frontiers in allergy","volume":"7 ","pages":"1862176"},"PeriodicalIF":3.4,"publicationDate":"2026-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13337878/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148407193","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}