“…Previous studies have reported a decrease in the expressions of filaggrin and claudins in cholesteatoma, which in parallel causes the increased permeability of this tissue. In addition, secreted lipids, such as ceramides, cholesterol and long‐chain free fatty acids, function as mortar in the epidermis, and are responsible for epidermal impermeability . The mechanical fragility of the epidermis depends on not only CDSN but also other structural proteins including keratins, filaggrin, invoculin, loricrin, envoplakin and periplakin .…”