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BACKGROUND: Autoimmune pemphigus is a group of severe, potentially fatal bullous dermatoses affecting both skin and mucous membranes. To date, the pathogenesis and therapeutic approaches to the disease have been well studied; despite this, secondary bacterial complications remain the leading cause of death in these patients. Study of qualitative and quantitative composition of skin microbiome in chronic dermatoses is an actual contemporary problem. These data allow one to investigate the influence of microorganisms on the disease severity, relapse rate and remission duration. Analysis of literature sources shows a high interest of scientific groups in the study of microbiome components of the skin and mucous membranes in patients with bullous dermatoses, however, similar works on autoimmune bullous vesicles are still limited. AIM: to compare the composition of the skin microbiome in patients with autoimmune pemphigus and a healthy control group based on the results of the culture method performed. MATERIALS AND METHODS: Experimental, prospective, comparative study. Seventeen patients with previously or first-time diagnosis of autoimmune vesicular disease, as well as a control group of 10 people were included in the study. Patients were enrolled between November 2021 and November 2022. Rakhmanov clinic. All study participants had their skin swabs taken (for patients with rash elements and with apparently unchanged skin in the back or chest area; for the control group, from healthy skin in the back area), after which the material was taken to the laboratory for culture study. RESULTS: Data from 17 patients (5 men, 29.5%; and 12 women, 70.5%; average age 5113.3 years) were analyzed. Also included were 10 individuals from the control group (7 women, 70%; and 3 men, 30%; mean age 4014.7 years). Bacterial growth was detected in all samples submitted. No other microgranisms were identified. Eleven bacterial species were detected on the skin from the rash elements. The most frequent species encountered were: Staphylococcus aureus (in 70.59% of patients), Staphylococcus epidermidis (35.3%), Staphylococcus hominis (17.63%), Staphylococcus haemolyticus and Corynebacterium aurimucosum (11.8%). Twelve bacterial species were isolated on visibly unchanged skin. The most frequent were S. epidermidis (52.9%), S. aureus and S. hominis (35.3%), Staphylococcus capitis and Staphylococcus warneri (17.65%), Micrococcus luteus (11.76%). Fifteen bacterial species were identified in the control group. The following species were found most frequently: S. hominis (60%), S. capitis (50%), M. luteus (40%), S. epidermidis, S. haemolyticus and S. warneri (20%). The mean value of bacterial colony-forming units per 1 ml on rash elements was 5106.338752.46; on visibly unchanged skin 593.231223.06; in the control group 349.33915.52. CONCLUSIONS: We were able to obtain primary data on the composition of the skin microbiome in 17 patients with various types of autoimmune pemphigus and compare them with the control group. The data obtained demonstrate a great variety of microbial communities on the skin and a significant quantitative difference in the composition on the skin of patients and controls. A limitation of the study is the chosen cultural method, which cannot fully reflect all the diversity of microorganisms. To confirm the hypotheses put forward, we plan to conduct an additional study involving a larger number of patients and using genomic sequencing methods to identify microbial communities.
BACKGROUND: Autoimmune pemphigus is a group of severe, potentially fatal bullous dermatoses affecting both skin and mucous membranes. To date, the pathogenesis and therapeutic approaches to the disease have been well studied; despite this, secondary bacterial complications remain the leading cause of death in these patients. Study of qualitative and quantitative composition of skin microbiome in chronic dermatoses is an actual contemporary problem. These data allow one to investigate the influence of microorganisms on the disease severity, relapse rate and remission duration. Analysis of literature sources shows a high interest of scientific groups in the study of microbiome components of the skin and mucous membranes in patients with bullous dermatoses, however, similar works on autoimmune bullous vesicles are still limited. AIM: to compare the composition of the skin microbiome in patients with autoimmune pemphigus and a healthy control group based on the results of the culture method performed. MATERIALS AND METHODS: Experimental, prospective, comparative study. Seventeen patients with previously or first-time diagnosis of autoimmune vesicular disease, as well as a control group of 10 people were included in the study. Patients were enrolled between November 2021 and November 2022. Rakhmanov clinic. All study participants had their skin swabs taken (for patients with rash elements and with apparently unchanged skin in the back or chest area; for the control group, from healthy skin in the back area), after which the material was taken to the laboratory for culture study. RESULTS: Data from 17 patients (5 men, 29.5%; and 12 women, 70.5%; average age 5113.3 years) were analyzed. Also included were 10 individuals from the control group (7 women, 70%; and 3 men, 30%; mean age 4014.7 years). Bacterial growth was detected in all samples submitted. No other microgranisms were identified. Eleven bacterial species were detected on the skin from the rash elements. The most frequent species encountered were: Staphylococcus aureus (in 70.59% of patients), Staphylococcus epidermidis (35.3%), Staphylococcus hominis (17.63%), Staphylococcus haemolyticus and Corynebacterium aurimucosum (11.8%). Twelve bacterial species were isolated on visibly unchanged skin. The most frequent were S. epidermidis (52.9%), S. aureus and S. hominis (35.3%), Staphylococcus capitis and Staphylococcus warneri (17.65%), Micrococcus luteus (11.76%). Fifteen bacterial species were identified in the control group. The following species were found most frequently: S. hominis (60%), S. capitis (50%), M. luteus (40%), S. epidermidis, S. haemolyticus and S. warneri (20%). The mean value of bacterial colony-forming units per 1 ml on rash elements was 5106.338752.46; on visibly unchanged skin 593.231223.06; in the control group 349.33915.52. CONCLUSIONS: We were able to obtain primary data on the composition of the skin microbiome in 17 patients with various types of autoimmune pemphigus and compare them with the control group. The data obtained demonstrate a great variety of microbial communities on the skin and a significant quantitative difference in the composition on the skin of patients and controls. A limitation of the study is the chosen cultural method, which cannot fully reflect all the diversity of microorganisms. To confirm the hypotheses put forward, we plan to conduct an additional study involving a larger number of patients and using genomic sequencing methods to identify microbial communities.
Our study revealed associations with dysregulation of the community of commensals connected with seborrheic dermatitis, metabolic syndrome (MS) and type 2 diabetes mellitus.The aim of the study was to identify the association of the severity of SD and changes in the bacterial composition of the skin microbiota in patients with facial SD, with facial SD and metabolic syndrome and in patients with facial SD with MS and type 2 diabetes mellitus.Material and methods.The study included 90 patients with seborrheic dermatitis, divided into 3 groups . The severity of the disease was determined by SEDASI score . Metabolic syndrome was diagnosed based on the criteria of NCEP ATP III. The diagnosis of diabetes mellitus was established according to the diagnostic criteria of diabetes mellitus and other glycemic disorders . A modified Leming-Notman dense medium was used to isolate yeast fungi of Malassezia spp. The cultures were obtained according to the Gold’s method. The species identification from clinical isolates was carried out using the mass spectrometry method on the MALDI-TOF MS "Biotyper RTC" device.Results.Significant changes in the number of bacterial species were observed in patients with moderate to severe diabetes mellitus. We found that the colonization of microorganisms on the facial skin significantly increased in patients of groups 2 and 3, compared with group 1. Among the isolated staphylococci in patients of groups 2 and 3, the growth of S. аureus, S. epidermidis, and S. hominis prevailed.Conclusion.The severity of the duration and widespread lesions on the facial skin in patients with seborrheic dermatitis, metabolic syndrome and with seborrheic dermatitis, metabolic syndrome and type 2 diabetes mellitus are interrelated with dysbiosis of the microbiota. The growth of microorganisms in patients with seborrheic dermatitis and impaired carbohydrate metabolism is associated with severe facial SD and plays a significant role in the pathogenesis of the disease.
The skin is structurally a complex barrier organ that forms an original dynamic ecosystem colonized by a wide range of bacteria, fungi, viruses, and mites. The skin microbiome plays an important role in maintaining homeostasis and the state of local immunity and affects pathogenic microorganisms and skin barrier function through bacterial enzyme production. The most frequent and common infectious skin lesions are pyoderma, atopic dermatitis, psoriasis, hidradenitis suppurativa, acne vulgaris, rosacea, seborrheic dermatitis, various mycoses, as well as bacterial and fungal folliculitis. A detailed study of the impact of homeostatic balance on the health of the skin plays an important role in the diagnosis and treatment of skin diseases. Further investigations and deciphering bacteria, fungi, and viruses colonizing the skin will contribute to more effective diagnosis and identification of associations between the microbiota and the occurrence of various diseases, as well as to the development of more effective methods for their treatment, which is of great importance in clinical practice.
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