THE ROLE OF THE SKIN MICROBIOME IN THE DEVELOPMENT OF DERMATOLOGIC DISEASES: CURRENT STATE OF EVIDENCE (2020–2025)

Julia Glińska; Filip Witowicz; Wiktoria Waldon; Weronika Spychalska; Kornelia Kaźmierkiewicz-Makanga; Maksymilian Bogacz; Aleksandra Krawczyk; Paulina  Sumlet; Maria Gofron; Michał Duliński

doi:10.31435/ijitss.2(50).2026.5278

Authors

Julia Glińska University Clinical Centre, Gdańsk, Poland https://orcid.org/0009-0007-6212-0541
Filip Witowicz University Clinical Centre, Gdańsk, Poland https://orcid.org/0009-0009-9600-2628
Wiktoria Waldon University Clinical Centre, Gdańsk, Poland https://orcid.org/0009-0008-4389-7205
Weronika Spychalska University Clinical Centre, Gdańsk, Poland https://orcid.org/0009-0005-1224-4330
Kornelia Kaźmierkiewicz-Makanga Nicolaus Copernicus University, Collegium Medicum in Bydgoszcz, Bydgoszcz, Poland https://orcid.org/0009-0008-1145-0302
Maksymilian Bogacz Poznan University of Medical Sciences, Poznań, Poland https://orcid.org/0009-0003-8665-3538
Aleksandra Krawczyk Copernicus PL Sp z o. o. Hospital św. Wojciecha, Gdańsk, Poland https://orcid.org/0009-0006-6317-1204
Paulina Sumlet 7th Naval Hospital in Gdańsk, Gdańsk, Poland https://orcid.org/0009-0008-1978-6409
Maria Gofron Medical University of Gdańsk, Gdańsk, Poland https://orcid.org/0009-0001-2719-5894
Michał Duliński Medical University of Gdańsk, Gdańsk, Poland https://orcid.org/0009-0004-2157-1053

DOI:

https://doi.org/10.31435/ijitss.2(50).2026.5278

Keywords:

Skin Microbiome, Dysbiosis, Precision Medicine, Metagenomics, Probiotics

Abstract

Background: The cutaneous microbiome is a sophisticated ecosystem essential for skin homeostasis and immune regulation. Between 2020 and 2025, research transitioned from simple taxonomic mapping toward functional metagenomics, highlighting the microbiome's role as a dynamic modifier of dermatologic pathology. This review synthesizes recent evidence on microbial involvement in inflammatory skin diseases and evaluates emerging therapeutic interventions.

Methods: A narrative synthesis was performed via a targeted PubMed search for literature published from January 2020 to December 2025. Following the screening of 171 abstracts, 33 high-impact studies focusing on functional metagenomics, "multi-omic" integration, and microbiome-targeted therapies were selected for in-depth analysis.

Results: In atopic dermatitis (AD), the correlation between Staphylococcus aureus dominance and barrier degradation remains the most robust evidence of clinically significant dysbiosis. In psoriasis, localized microbial shifts are intrinsically linked to Th17/IL-23 axis activation. Acne vulgaris pathogenesis is increasingly attributed to specific virulent Cutibacterium acnes phylotypes rather than absolute abundance. In seborrheic dermatitis, the synergistic interaction between Malassezia fungi and bacterial commensals drives inflammatory signaling. Precision interventions, including strain-targeted probiotics, postbiotics, and skin microbiome transplantation (SMT), demonstrate mechanistic rationale and early-phase feasibility.

Conclusions: Emerging evidence suggests a potential transition in dermatological therapeutics from broad-spectrum antimicrobial suppression toward targeted ecological restoration. However, this approach remains largely investigational and requires validation through rigorous clinical trials. Future progress depends on standardized sampling protocols and the application of machine learning to identify "microbial endotypes," enabling the development of personalized, microbiome-based therapeutic strategies.

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