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Many relatively common chronic inflammatory skin diseases manifest on the face (seborrheic dermatitis, rosacea, acne, perioral/periorificial dermatitis, periocular dermatitis, etc.), thereby significantly imparing patient appearance and quality of life. Given the as yet unexplained pathogenesis and numerous factors involved, these diseases often present therapeutic challenges. Changes in human skin microbiota composition and/or functionality are believed to trigger immune dysregulation and, consequently, an inflammatory response, thereby playing a potentially significant role in the clinical manifestations and treatment of these diseases. Although cultivation methods have traditionally been used in studies of bacterial microbiome species, a large number of bacterial strains cannot be grown in the laboratory. Since standard culture-dependent methods detect fewer than 1% of all bacterial species, a metagenomic approach could be used to detect bacteria that cannot be cultivated. Studies on the possible association between changes in the microbiome and their association with skin diseases have improved understanding of disease development, diagnostics and therapeutics. Identification of the bacterial markers associated with particular inflammatory skin diseases would significantly accelerate the diagnostics and reduce treatment costs. Microbiota research and determination could facilitate the identification of potential causes of skin diseases that cannot be detected by simpler methods, thereby contributing to the design and development more effective therapies.
Atopic dermatitis | ↑ Staphylococcus spp. 1 3 7 8 ↑ Staphylococcus aureus 1 2 3 4 5 6 8 ↑ Staphylococcus epidermidis 1 4 7 |
↓ Streptococcus spp. 1 ↓ Cutibacterium spp. 1 3 ↓ Corynebacterium spp. 1 3 |
Psoriasis | ↑ Firmicutes 9 10 ↑ Proteobacteria 11 14 ↑ Streptococcus spp. 9 ↑ Prevotella 10 ↑ Staphylococcus spp. 10 13 ↑ Staphylococcus aureus 11 ↑ Staphylococcus pettenkoferi 11 ↑ Staphylococcus sciuri 11 |
↓ Actinobacteria 9 10 11 12 ↓ Gordoniaceae 11 ↓ Proteobacteria 9 ↓ Staphylococcus epidermidis 11 ↓ Cutibacterium spp. 9 10 14 ↓ Staphylococcus spp. 14 ↓ Cutibacterium acnes 11 ↓ Cutibacterium granulosum 11 |
Seborrheic dermatitis | ↑ Staphylococcus spp. 15 16 17 18 19 20 21 22 ↑ Staphylococcus epidermidis 20 ↑ Streptococcus spp. 18 ↑ Pseudomonas spp. 22 ↑ Acinetobacter 18 |
↓ Cutibacterium spp. 15 16 17 19 20 21 |
Acne | ↑ Firmicutes 24 25 ↑ Proteobacteria 23 24 ↑ Staphylococcus spp. 24 25 |
↓ Actinobacteria 23 24 ↓ Cutibacterium spp. 23 ↓ Cutibacterium acnes 23 ↓ Cutibacterium granulosum 23 |
Rosacea | ↑ Corynebacterium kropp 26 ↑ Gordonia 27 ↑ Geobacillus 27 |
↓ Rosemonas spp. 26 |
According to data gathered on the epidermal barrier disorder observed in patients with perioral dermatitis, microbiome research could give important conclusions about the microbiome of the perioral region. To date, studies on the skin microbiome of the periorificial region are few. Zheng et al. found that bacteria of the genera Streptococcus and Rothia predominate on the skin of the perioral region of healthy infants [44].
The microbiome of healthy periocular skin harbors coagulase negative Staphylococci (Staphylococcus epidermidis), Staphylococcus aureus and Cutibacterium acnes, whose presence is not always considered pathological but may play a role in Meibomian gland dysfunction [45][46]. Another common finding on the skin of the periocular region is Demodex mite which is observed in healthy individuals but even more common in patients with blepharitis, where it plays a yet insufficiently elucidated role [46]. The skin of the periocular region in healthy individuals is inhabited mostly by bacteria from the phyla Actinobacteria, followed by Firmicutes, Proteobacteria, and Bacteroidetes, which corresponds to the findings of other seborrheic skin localizations [47][48].
Studies by Alekseyenko et al., Wang et al. and Langan et al. showed that the biodiversity in psoriatic lesions is reduced compared to healthy skin [49][50][51]. A study by Chang et al. found increased biodiversity in skin affected by psoriasis, while a study by Fahlen et al. found no difference [52][53]. The most abundant bacteria harboring psoriatic lesions are the bacteria of the Firmicutes phylum which are present on psoriatic skin in a larger proportion than on the skin of healthy subjects [53][54], whereas the phyla Actinobacteria [50][52][55][53][54] and Proteobacteria are reduced [54]. Aside from that, studies show an increase in the abundance of Streptococcus [54] and Staphylococcus genera [56][57], i.e., certain species of Staphylococcus aureus, Staphylococcus pettenkoferi and Staphylococcus sciuri, and the depletion of the genus Cutibacterium, Staphylococcus epidermidis, Cutibacterium acnes and Cutibacterium granulosum species [52][54].
Alekseyenko et al. found that the genera Corynebaterium, Cutibacterium, Staphylococcus and Streptococcus are more abundant in patients with psoriasis, while the genera Cupriavidus, Methylobacterium and Schlegelella are less abundant [49]. It has also been shown that there are two types of psoriasis, based on the abundance of certain bacteria - type 1, with the predominance of Proteobacteria phylum and type 2, with the predominance of Firmicutes and Actinobacteria phyla. Fahlén et al. analyzed the microbiome using skin bioptates and showed that the phylum Proteobacteria was more prevalent on the trunks of patients with psoriasis than on those of healthy subjects, while the genera Cutibacterium and Staphylococcus were reduced on the affected skin of the limbs [55]