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    How cutaneous microbiome impacts skin disease

    Elements, implications, and nuances are driving factors

    Matthew J. Zirwas, M.D.Sometimes, seeing the big picture means drilling down to consider the smallest components that comprise the overall canvas. This is clearly true when considering the skin and when considering the microbiomes that cooperate to paint the larger picture.

    READ: Unexplored skin virus population revealed

    Matthew J. Zirwas, M.D., director, Ohio Contact Dermatitis Center, says, “We know that the skin is colonized by a variety of organisms (bacteria and yeast primarily), most of which are probably beneficial. The innate immune system protects us from most of the pathogenic organisms and, in different inflammatory diseases, the activity of the innate immune system may be increased (as in psoriasis) or decreased (as in atopic dermatitis). These changes lead to alterations in the cutaneous microbiome which may be a factor in disease activity. It is also possible that changes in the cutaneous microbiome, independent of innate immunity, could be driving factors in some diseases.”

    Adam Friedman, M.D.Adam Friedman, M.D., FAAD, associate professor of dermatology, residency program director, director of translational research, department of dermatology, George Washington School of Medicine and Health Sciences, speaks to the science of the cutaneous microbiome. “It’s easy to dismiss this field at first glance as pseudoscience, given the very generalized claims made regarding over-the-counter products containing probiotics—but what are probiotics? They’re live bacteria and yeast (the term is non-specific) and subject, like many other elements making up the cutaneous picture, to mislabeling.

    ALSO READ: Microbial sonderations in rosacea treatment

    “So definitions are really important,” Dr. Friedman explains. “The lay and medical communities often refer to this area of study incorrectly. The microbiome is actually the collective genome of all the microorganisms on the skin. It’s not the actual organisms themselves. ‘Microbiota’ is actually the collection of microbial populations. The way we’re identifying the microbiota is through their genetic fingerprint. Through that microbiome. That’s how we identify who is at the party, which can vary tremendously even from one body area to the other.”

    NEXT: Shedding light on the whole picture

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