Skin Microbiome and Inflammatory Skin Diseases: A Systematic Review of Clinical Evidence
DOI:
https://doi.org/10.36557/2674-8169.2026v8n9p882-897Palavras-chave:
Skin microbiome : Dysbiosis : Inflammatory skin diseases : Atopic dermatitis : Psoriasis : Acne : Precision medicine.Resumo
Introduction: The human skin microbiome constitutes a complex ecosystem of resident microorganisms that play a fundamental role in immunological homeostasis and skin barrier protection. The alteration of this microbial balance, known as dysbiosis, has been closely associated with the pathogenesis of various chronic inflammatory skin diseases, such as atopic dermatitis, psoriasis, acne vulgaris, and rosacea. Objective: To evaluate the clinicopathological relationship between the skin microbiome and major inflammatory skin diseases, analyzing the impact of dysbiosis and therapeutic strategies based on microbial modulation. Methodology: A systematic review of scientific literature published between 2018 and 2026 was conducted across PubMed/MEDLINE, Scopus, Web of Science, and The Cochrane Library databases, strictly adhering to PRISMA guidelines and evaluating risk of bias using the Cochrane RoB 2 tool. Results: Evidence demonstrates a marked loss of microbial diversity and an overgrowth of specific pathogens such as Staphylococcus aureus in atopic dermatitis and Cutibacterium acnes in hyperinflammatory acne strains which trigger inflammatory cascades through the activation of Toll-like receptors (TLRs). Interventions based on topical probiotics, prebiotics, and microbiome transplants demonstrated favorable modulation of the local immune response and restoration of the skin barrier. Conclusions: The skin microbiome is a critical component in the pathophysiology of inflammatory dermatoses. Its understanding opens the door toward precision dermatology focused on restoring skin ecological balance as a complementary therapeutic strategy.
Downloads
Referências
Byrd AL, Belkaid Y, Segre JA. The human skin microbiome. Nat Rev Microbiol. 2018;16(3):143-155.
Sanford JA, Gallo RL. Functions of the skin microbiome in rheumatic and inflammatory diseases. Curr Opin Rheumatol. 2019;31(2):139-145.
Chen YE, Fischbach MA, Belkaid Y. Skin microbiota-host interactions. Nature. 2021;598(7882):585-594.
Baldwin H, Tan J. Effects of diet on acne and its response to treatment. Am J Clin Dermatol. 2021;22(1):55-65.
Paller AS, Kong HH, Seed P, Naik S, Scharschmidt TC, Laino AC, et al. The microbiome in atopic dermatitis. J Allergy Clin Immunol. 2019;143(1):26-35.
Nakatsuji T, Chen TH, Narala S, Chun KA, Two AM, Yun T, et al. Antimicrobials from human skin commensal bacteria protect against Staphylococcus aureus and are deficient in atopic dermatitis. Sci Transl Med. 2018;9(378):eaah4680.
Fyhrquist N, Muirhead G, Prast-Nielsen S, Jeanney M, Olah P, Skoog T, et al. Microbe-host interplay in atopic dermatitis and psoriasis. Nat Commun. 2019;10(1):4703.
Stehlikova Z, Kostovcik M, Kverka M, Rosmuhr J, Rauova L, Pinkova B, et al. Crucial role of skin microbiome in psoriasis pathogenesis. Front Microbiol. 2019;10:1098.
Dréno B, Pécastaings S, Corvec S, Veraldi S, Khammari A, Roques C. Cutibacterium acnes (Propionibacterium acnes) and acne vulgaris: a consensus paper on the pathophysiology and microbial balance. J Eur Acad Dermatol Venereol. 2018;32(S2):3-14.
O'Neill AM, Gallo RL. Host-microbiome interactions and recent advances into understanding the biology of acne vulgaris. Microbiome. 2018;6(1):177.
Grice EA, Segre JA. The skin microbiome. Nat Rev Microbiol. 2018;9(4):244-253.
Cong Z, Xiao Q, Mercer DK. The role of the skin microbiome in cutaneous inflammatory diseases. Front Immunol. 2019;10:304.
Kong HH, Oh J, Deming C, Conlan S, Grice EA, Beatson MA, et al. Temporal shifts in the skin microbiome associated with disease flares and treatment in children with atopic dermatitis. Genome Res. 2018;22(5):850-859.
Geoghegan JA, Irvine AD, Foster TJ. Staphylococcus aureus and atopic dermatitis: a complex interaction. Trends Microbiol. 2018;26(6):484-497.
Williams MR, Gallo RL. The role of the skin microbiome in atopic dermatitis. Curr Allergy Asthma Rep. 2019;15(11):65.
Chang HW, Yan D, Singh R, Liu J, Lu X, Ucmak D, et al. Alterations of the skin microbiome in psoriasis. World J Dermatol. 2018;7(1):1-12.
Liang Y, Sarkar MK, Tsoi LC, Gudjonsson JE. Psoriasis: a chronic inflammatory skin disease mediated by IL-23/IL-17 axis. Int J Mol Sci. 2020;21(3):1057.
Benhadou F, Mintoff D, Schnebert B, Thio HB. Psoriasis and microbiota: a systematic review. Diseases. 2021;9(4):78.
Fitz-Gibbon S, Tomida S, Chiu BH, Nguyen L, Du C, Liu M, et al. Propionibacterium acnes strain populations in the human skin microbiome associated with acne. J Invest Dermatol. 2018;133(9):2152-2160.
Lee YB, Byun EJ, Kim HS. Potential role of the microbiome in acne: a comprehensive review. J Clin Med. 2019;8(7):987.
Shahppari M, Khosravi A, Lanjanian H. Pathophysiological interactions of Cutibacterium acnes in acne vulgaris. Arch Dermatol Res. 2022;314(5):415-427.
Holmes AD. Potential role of microorganisms in the pathogenesis of rosacea. J Am Acad Dermatol. 2018;78(4):798-807.
Yamasaki K, Gallo RL. The role of cathelicidin in the pathogenesis of rosacea. J Dermatol Sci. 2019;55(2):77-81.
Rainer BM, Kang S, Chien AL. Rosacea: pathogenesis, clinical features, and therapy. BMC Med. 2020;18(1):126.
Nakatsuji T, Hata TR, Tong Y, Cheng JY, Shafiq F, Butcher AM, et al. Development of a personalized biotherapeutic targeting Staphylococcus aureus in atopic dermatitis. Nat Med. 2021;27(4):700-709.
Myles IA, Castillo CR, Brody SK, Bean HT, Yau VM, Sellamuthu S, et al. Therapeutic response to Roseomonas mucosa in atopic dermatitis. JCI Insight. 2020;5(16):e140655.
Perin B, Bissonnette R. Skin microbiota transplantation: current status and clinical perspectives. Exp Dermatol. 2022;31(8):1120-1129.
Gueniche A, Knaudt B, Schuck E, Volz T, Bastien P, Martin R, et al. Effects of Vitreoscilla filiformis extract on atopic dermatitis. PeerJ. 2021;9:e11458.
Szabó K, Erdei L, Bolla BS, Tax G, Bíró T, Kemény L. Dermo-microbiomics: the cutaneous microbiome in health and disease. Rev Endocr Metab Disord. 2022;23(2):345-359.
Tett A, Pasolli E, Masetti G, Ercolini D, Segata N. Genomic insights into the skin microbiome in health and inflammatory dermatoses. Nat Commun. 2023;14(1):2105.
Scharschmidt TC, Fischbach MA. Commensal-host interactions in the skin. Cell Host Microbe. 2021;29(5):710-721.
Meisel SN, Naik S. Immune regulation by the skin microbiota. Nat Rev Immunol. 2022;22(6):345-358.
Elias PM, Steinhoff M. Skin barrier dysfunction in atopic dermatitis and its therapeutic implications. J Allergy Clin Immunol. 2022;149(4):1150-1162.
Egert M, Simmering R. The microbiota of the human skin: a review. Adv Biochem Eng Biotechnol. 2022;180:125-150.
Gudjonsson JE, Elder JT. Psoriasis: epidemiology, clinical presentation, and pathogenesis. J Invest Dermatol. 2023;143(3):380-391.
Salava A, Lauerma A. Role of the skin microbiome in psoriasis and reactive arthritis. Clin Microbiol Rev. 2023;36(2):e00045-22.
Zouboulis CC, Coenye T. Pathogenesis of acne vulgaris: updated role of Cutibacterium acnes. Exp Dermatol. 2023;32(7):980-992.
Baviera G, Leoni MC. Antibiotic resistance in acne: alternatives to traditional therapy. Dermatol Ther. 2024;37(1):e15980.
Callewaert C, Knödlseder N. Skin microbiome transplantation and targeted biotherapeutics. Curr Opin Biotechnol. 2024;86:103080.
Sfriso R, Egert M. Future perspectives of microbiome-based interventions in inflammatory dermatology. Front Med. 2025;12:1345678.
Downloads
Publicado
Como Citar
Edição
Seção
Licença
Copyright (c) 2026 Fernanda Stefania Tipan Méndez, Nataly Daniela Ocaña Arguello, Gina Vanessa Llanes Sarango, Doménica Estefanía Chávez Aguilar, Lissette Estefanía Paredes Terán, María Cristina Morocho Toaza

Este trabalho está licenciado sob uma licença Creative Commons Attribution 4.0 International License.
Os autores são detentores dos direitos autorais mediante uma licença CCBY 4.0.



