CURRENT PERSPECTIVES ON THE ROLE OF THE CUTANEOUS MICROBIOME IN CHRONIC INFLAMMATORY SKIN DISEASES
DOI:
https://doi.org/10.31435/ijitss.3(47).2025.3790Keywords:
Skin Microbiota, Chronic Inflammatory Dermatoses, Atopic Dermatitis, Psoriasis, Acne Vulgaris, Microbiome TransplantationAbstract
Objective: The skin microbiome is a complex ecosystem of bacteria, viruses, fungi, and archaea that interacts with host cells to regulate defense mechanisms, immune responses, colonization resistance, and tissue repair. This review aims to summarize current knowledge on the role of the skin microbiome in the course and treatment of chronic inflammatory dermatoses, including atopic dermatitis, psoriasis, and acne vulgaris.
Materials and methods: A literature review was performed using PubMed and Google Scholar databases. Keywords included: skin microbiota, skin microbiome, chronic inflammatory dermatoses, atopic dermatitis, psoriasis, acne vulgaris, microbiome transplantation, probiotics, prebiotics, and postbiotics. A total of 36 articles published between 2008 and 2024 were analyzed for relevance.
Description: Patients with atopic dermatitis show reduced microbial diversity, characterized by Staphylococcus aureus overgrowth and decreased commensal bacteria such as Streptococcus, Corynebacterium, Cutibacterium, and Proteobacteria. In psoriasis, decreased levels of Corynebacterium spp., Lactobacillus spp., and Cutibacterium acnes are common. Acne vulgaris is linked to excessive sebum production, abnormal follicular keratinization, Cutibacterium acnes colonization, and inflammation.
Strategies to modulate the skin microbiome include microbiome transplantation and bacteriotherapy, which applies selected beneficial strains to disinfected skin. These methods may offer more practical alternatives than full transplantation. Additionally, prebiotic compounds can promote the growth of protective microbes, while probiotics and postbiotics are increasingly studied for their therapeutic effects.
Conclusions: Chronic inflammatory dermatoses significantly impair quality of life. Evidence suggests that targeting the skin microbiome holds therapeutic potential. Further studies are needed to clarify microbiota–host interactions, consequences of dysbiosis, and the clinical utility of microbiome-based interventions.
References
Chen YE, Fischbach MA, Belkaid Y. Skin microbiota-host interactions. Nature. 2018 Jan 24;553(7689):427-436. doi: 10.1038/nature25177. Erratum in: Nature. 2018 Mar 21;555(7697):543. doi: 10.1038/nature25994. PMID: 29364286; PMCID: PMC6075667.
Flowers L, Grice EA. The Skin Microbiota: Balancing Risk and Reward. Cell Host Microbe. 2020 Aug 12;28(2):190-200. doi: 10.1016/j.chom.2020.06.017. PMID: 32791112; PMCID: PMC7444652.
Uberoi A, Bartow-McKenney C, Zheng Q, Flowers L, Campbell A, Knight SAB, Chan N, Wei M, Lovins V, Bugayev J, Horwinski J, Bradley C, Meyer J, Crumrine D, Sutter CH, Elias P, Maul E, Sutter TR, Grice EA. Commensal microbiota regulates skin barrier function and repair via signaling through the aryl hydrocarbon receptor. Cell Host Microbe. 2021 Aug11;29(8):1235-1248.e8. doi: 10.1016/j.chom.2021.05.011. Epub 2021 Jul 1. PMID: 34214492; PMCID: PMC8364505.
Smythe P, Wilkinson HN. The Skin Microbiome: Current Landscape and Future Opportunities. Int J Mol Sci. 2023 Feb 16;24(4):3950. doi: 10.3390/ijms24043950. PMID: 36835363; PMCID: PMC9963692.
Tomic-Canic M, Burgess JL, O'Neill KE, Strbo N, Pastar I. Skin Microbiota and its Interplay with Wound Healing. Am J Clin Dermatol. 2020 Sep;21(Suppl 1):36-43. doi: 10.1007/s40257- 020-00536-w. PMID: 32914215; PMCID: PMC7584558.
Wolcott RD, Hanson JD, Rees EJ, Koenig LD, Phillips CD, Wolcott RA, Cox SB, White JS. Analysis of the chronic wound microbiota of 2,963 patients by 16S rDNA pyrosequencing. Wound Repair Regen. 2016 Jan-Feb;24(1):163-74. doi: 10.1111/wrr.12370. Epub 2015 Dec10. PMID: 26463872.
Sánchez-Pellicer P, Navarro-Moratalla L, Núñez-Delegido E, Ruzafa-Costas B, Agüera-Santos J, Navarro-López V. Acne, Microbiome, and Probiotics: The Gut-Skin Axis. Microorganisms. 2022 Jun 27;10(7):1303. doi: 10.3390/microorganisms10071303. PMID: 35889022; PMCID: PMC9318165.
Oh J., Byrd AL, Park M., Kong HH, Segre JA Temporal Stability of the Human Skin Microbiome. Cell. 2016;165:854–866. doi: 10.1016/j.cell.2016.04.008.
Sroka-Tomaszewska J, Trzeciak M. Molecular Mechanisms of Atopic Dermatitis Pathogenesis. Int J Mol Sci. 2021 Apr 16;22(8):4130. doi: 10.3390/ijms22084130. PMID: 33923629; PMCID: PMC8074061
Torres T, Ferreira EO, Gonçalo M, Mendes-Bastos P, Selores M, Filipe P. Update on Atopic Dermatitis. Acta Med Port. 2019 Sep 2;32(9):606-613. doi: 10.20344/amp.11963. Epub 2019 Sep 2. PMID: 31493365
Langan SM, Irvine AD, Weidinger S. Atopic dermatitis. Lancet. 2020 Aug 1;396(10247):345-360. doi: 10.1016/S0140-6736(20)31286-1. Erratum in: Lancet. 2020 Sep 12;396(10253):758. doi: 10.1016/S0140-6736(20)31825-0. PMID: 32738956
Mohammad S, Karim MR, Iqbal S, Lee JH, Mathiyalagan R, Kim YJ, Yang DU, Yang DC. Atopic dermatitis: Pathophysiology, microbiota, and metabolome - A comprehensive review. Microbiol Res. 2024 Apr;281:127595. doi: 10.1016/j.micres.2023.127595. Epub 2024 Jan 3. PMID: 38218095
Edslev SM, Agner T, Andersen PS. Skin Microbiome in Atopic Dermatitis. Acta Derm Venereol. 2020 Jun 9;100(12):adv00164. doi: 10.2340/00015555-3514. PMID: 32419029; PMCID: PMC9189751
Frazier W, Bhardwaj N. Atopic Dermatitis: Diagnosis and Treatment. Am Fam Physician. 2020 May 15;101(10):590-598. PMID: 32412211
Koh LF, Ong RY, Common JE. Skin microbiome of atopic dermatitis. Allergol Int. 2022 Jan;71(1):31-39. doi: 10.1016/j.alit.2021.11.001. Epub 2021 Nov 24. PMID: 34838450
Shi B, Bangayan NJ, Curd E, Taylor PA, Gallo RL, Leung DYM, Li H. The skin microbiome is different in pediatric versus adult atopic dermatitis. J Allergy Clin Immunol. 2016 Oct;138(4):1233-1236. doi: 10.1016/j.jaci.2016.04.053. Epub 2016 Jun 29. PMID: 27474122; PMCID: PMC5235385
Rendon A, Schäkel K. Psoriasis Pathogenesis and Treatment. Int J Mol Sci. 2019 Mar 23;20(6):1475. doi: 10.3390/ijms20061475. PMID: 30909615; PMCID: PMC6471628
Kamiya K, Kishimoto M, Sugai J, Komine M, Ohtsuki M. Risk Factors for the Development of Psoriasis. Int J Mol Sci. 2019 Sep 5;20(18):4347. doi: 10.3390/ijms20184347. PMID: 31491865; PMCID: PMC6769762
Petit RG, Cano A, Ortiz A, Espina M, Prat J, Muñoz M, Severino P, Souto EB, García ML, Pujol M, Sánchez-López E. Psoriasis: From Pathogenesis to Pharmacological and Nano- Technological-Based Therapeutics. Int J Mol Sci. 2021 May 7;22(9):4983. doi: 10.3390/ijms22094983. PMID: 34067151; PMCID: PMC8125586
Olejniczak-Staruch I, Ciążyńska M, Sobolewska-Sztychny D, Narbutt J, Skibińska M, Lesiak A. Alterations of the Skin and Gut Microbiome in Psoriasis and Psoriatic Arthritis. Int J Mol Sci. 2021 Apr 13;22(8):3998. doi: 10.3390/ijms22083998. PMID: 33924414; PMCID: PMC8069836
Celoria V, Rosset F, Pala V, Dapavo P, Ribero S, Quaglino P, Mastorino L. The Skin Microbiome and Its Role in Psoriasis: A Review. Psoriasis (Auckl). 2023 Oct 26;13:71-78. doi: 10.2147/PTT.S328439. PMID: 37908308; PMCID: PMC10614657
Gao Z, Tseng CH, Strober BE, Pei Z, Blaser MJ. Substantial alterations of the cutaneous bacterial biota in psoriatic lesions. PLoS One. 2008 Jul 23;3(7):e2719. doi: 10.1371/journal.pone.0002719. PMID: 18648509; PMCID: PMC2447873;
Alekseyenko AV, Perez-Perez GI, De Souza A, Strober B, Gao Z, Bihan M, Li K, Methé BA, Blaser MJ. Community differentiation of the cutaneous microbiota in psoriasis. Microbiome. 2013 Dec 23;1(1):31. doi: 10.1186/2049-2618-1-31. PMID: 24451201; PMCID: PMC4177411.
Arya P, Kaur M, Chosyang S, Kushwaha N, Singh B. Decrypting Skin Microbiome in Psoriasis: Current Status. J Psoriasis Psoriatic Arthritis. 2023 Oct;8(4):166-178. doi: 10.1177/24755303231194293. Epub 2023 Aug 11. PMID: 39301472; PMCID: PMC11361554;
Fahlén A, Engstrand L, Baker BS, Powles A, Fry L. Comparison of bacterial microbiota in skin biopsies from normal and psoriatic skin. Arch Dermatol Res. 2012 Jan;304(1):15-22. doi: 10.1007/s00403-011-1189-x. Epub 2011 Nov 8. PMID: 22065152.
Mazur M, Tomczak H, Lodyga M, Czajkowski R, Żaba R, Adamski Z. The microbiome of the human skin and its variability in psoriasis and atopic dermatitis. Postepy Dermatol Alergol. 2021 Apr;38(2):205-209. doi: 10.5114/ada.2021.106197. Epub 2021 May 22. PMID:34408590; PMCID: PMC8362745.
Chilicka K, Dzieńdziora-Urbińska I, Szyguła R, Asanova B, Nowicka D. Microbiome and Probiotics in Acne Vulgaris—A Narrative Review. Life (Basel). 2022 Mar 15;12(3):422. doi: 10.3390/life12030422. PMID: 35330173; PMCID: PMC8953587.
Oge' LK, Broussard A, Marshall MD. Acne Vulgaris: Diagnosis and Treatment. Am Fam Physician. 2019 Oct 15;100(8):475-484. PMID: 31613567
Xu H, Li H. Acne, the Skin Microbiome, and Antibiotic Treatment. Am J Clin Dermatol. 2019 Jun;20(3):335-344. doi: 10.1007/s40257-018-00417-3. PMID: 30632097; PMCID: PMC6534434
Dréno B, Dagnelie MA, Khammari A, Corvec S. The Skin Microbiome: A New Actor in Inflammatory Acne. Am J Clin Dermatol. 2020 Sep;21(Suppl 1):18-24. doi: 10.1007/s40257- 020-00531-1. PMID: 32910436; PMCID: PMC7584556.
Dréno B, Pécastaings S, Corvec S, Veraldi S, Khammari A, Roques C. Cutibacterium acnes (Propionibacterium acnes) and acne vulgaris: a brief look at the latest updates. J Eur Acad Dermatol Venereol. 2018 Jun;32 Suppl 2:5-14. doi: 10.1111/jdv.15043. PMID: 29894579
Sánchez-Pellicer P, Navarro-Moratalla L, Núñez-Delegido E, Ruzafa-Costas B, Agüera-Santos J, Navarro-López V. Acne, Microbiome, and Probiotics: The Gut-Skin Axis. Microorganisms. 2022 Jun 27;10(7):1303. doi: 10.3390/microorganisms10071303. PMID: 35889022; PMCID: PMC9318165
França K. Topical Probiotics in Dermatological Therapy and Skincare: A Concise Review. Dermatol Ther (Heidelb). 2021 Feb;11(1):71-77. doi: 10.1007/s13555-020-00476-7. Epub 2020 Dec 19. PMID: 33340341; PMCID: PMC7859136.
Callewaert C, Knödlseder N, Karoglan A, Güell M, Paetzold B. Skin microbiome transplantation and manipulation: Current state of the art. Comput Struct Biotechnol J. 2021 Jan 4;19:624-631. doi: 10.1016/j.csbj.2021.01.001. PMID: 33510866; PMCID: PMC7806958.
Chan AA, Flores EA, Navarrete M, Phan Tran D, Lee DJ, Miller LG. The Effect of Systemic Antibiotics for Suppurative Skin and Soft Tissue Infections on the Skin Microbiome. Open Forum Infect Dis. 2022 Mar 22;9(5):ofac141. doi: 10.1093/ofid/ofac141. PMID: 35450081; PMCID: PMC9017368.
Lam M, Hu A, Fleming P, Lynde CW. The Impact of Acne Treatment on Skin Bacterial Microbiota: A Systematic Review. J Cutan Med Surg. 2022 Jan-Feb;26(1):93-97. doi: 10.1177/12034754211037994. Epub 2021 Aug 15. PMID: 34396785; PMCID: PMC8750125.
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