Appreciating the role of microbial communities on the skin
Future dermatological therapies may target restoring balance to the microbiome
New tools that assess the presence and quantities of organisms on the skin and the skin microbiome are opening doors to new therapies, says Lawrence F. Eichenfield, M.D., a Professor of Dermatology and Pediatrics, Vice Chair, Department of Dermatology, Chief, Pediatric and Adolescent Dermatology, University of California, San Diego School of Medicine, Rady Children's Hospital, San Diego, CA.
"When we are taking cultures, we are only looking at a small subset of organisms that are on the skin," says Dr. Eichenfield, in an interview with Dermatology Times. "The tools are evolving from media that allow you to grow a select subset of bacterial culture to genomic techniques that assess the presence and quantities of organisms reflected by their genetic material on the skin. The skin (microbiome) and the gut (microbiome) are areas of very hot research. Both are important interfaces between the outside and the inside. There is an interplay between us and the organisms around us. We live in the environment, and microbes are in the environment, and a set of microbes lives with us and on or in us."
Earlier this year, a symposium was held at the annual meeting of the Canadian Dermatology Association on the role of the microbiome in skin pathologies.
The knowledge being gained from more specific and expanded genomic analysis is being used to provide insights about common pediatric conditions such as diaper rash, explains Dr. Eichenfield.
Proper cleansing of the diaper area requires maintaining function of the skin barrier and repairing the barrier when necessary. Factors involved in care of the diaper area include the pH of the skin, irritant and allergic potential of contactants, topical agents that are applied, as well as the local microbiome.1
"In pediatric dermatology, we are interested in the developmental changes that happen in microbial colonization," says Dr. Eichenfield. "A condition like diaper rash is influenced by what is in the stool and what is in the gut."