Dr. Tom Colletti
In 2013, 85 million Americans saw their physician for at least one skin disease as reported by the Journal of the American Academy of Dermatology.1 Patients present seeking treatment for a wide range of conditions, from the seemingly benign teenage acne cases to severe autoimmune diseases like atopic dermatitis or psoriasis. Increasingly, the impact of the skin and gut microbiome in dermatologic conditions, as well as their role in maintaining normal, healthy skin has been examined. Changes in bacterial load and composition have been associated with the clinical presentation of skin diseases ranging from atopic dermatitis and eczema, to allergic reactions and even psoriasis. Human skin plays host to a complex community of organisms that varies throughout the different regions of the body.2 Through clinical research, we are gaining an understanding of how our normal flora, both skin and gut, relates to maintaining healthy skin and how changes in this microbial balance may exacerbate or alleviate these conditions. Recent increases in research interest, combined with improved methods of identification have made our perception of the microbiota’s involvement in patients suffering from skin disease more robust. We are coming closer to developing treatment options that may include replacing or altering the resident microbes of both the skin and the gut. Appreciation of the link between the flora that we host and our susceptibility and response to skin disease is becoming clearer and is likely to usher in a host of novel treatment modalities in the near future.
1. Lim HW, Collins SAB, Resneck JS, et al. The burden of skin disease in the united states. J Am Acad Dermatol. 2017;76(5):972.e2. doi: 10.1016/j.jaad.2016.12.043.
2. Grice EA, Segre JA. The skin microbiome. Nature Reviews Microbiology. 2011;9(4):244. doi: 10.1038/nrmicro2537.
Notabartolo JV. The Microbiome: The Role of Bacteria in Cutaneous Disease. Lynchburg Journal of Medical Science. 2019; 1(2).
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