The current emphasis on the neonatal intestinal microbiome has broadened everyone’s knowledge of the complex interaction between the intestinal barrier, commensal and pathogenic organisms and the developing immune system. Huge gaps still exist in the understanding of the infantile cutaneous microbiome, even though the equivalent role of the infant skin serves as both a barrier and also a border for preparing the immune system.

The skin microbiome keeps changing and maturing during infancy and becomes more diverse and develops the site specificity that is known to exist in adults. Delivery technique primarily defines the composition of the cutaneous microbiome, even though the effect seems temporary. Cutaneous microbes play an important role in the development of the immune system, mostly during the neonatal period. Microbes and immune cells are closely entangled with reciprocal effects. The unique structure of the new-born skin also influences the cutaneous microbial colonization and also the development of pathology in dermatological issues. The development of the infantile skin barrier and cutaneous microbiome can also add to the future pathology of the skin.

Atopic dermatitis has flares and along with seborrheic dermatitis is linked to dysbiosis, whereas erythema toxicumneonatorum is an immune response to the formation of normal bacterial skin flora. Physicians caring for infants should be alert of the impact of the infantile skin microbiome and regarding its role in the development of pathology. A better knowledge of the source and development of the skin microbiome can lead to effective prevention and treatment of skin disease in the pediatric population.

Source: Schoch JJ, Monir RL, Satcher KG, Harris J, Triplett E, Neu J. The infantile cutaneous microbiome: A review. PediatrDermatol. 2019; 36(5):574-580. doi:10.1111/pde.13870