The skin microbiome remains a prime aspect of pathogenesis in atopic dermatitis (AD). The skin of AD patients features microbial dysbiosis, with a reduction of microbial diversity and overrepresentation of pathogenic Staphylococcus aureus. 

Recent studies have clarified the importance of establishing an appropriate immune response to microbes in early life and unveiled the new mechanisms of microbial community dynamics in modulating our skin microbiome. 

Various microbes are associated with AD pathogenesis, with proposed pathogenic effects from S. aureus and Malassezia. The complex relationships between microbes within the skin microbiome consortia involve multiple species, such as Staphylococcal, Roseomonas, and Cutibacterium strains, that can impede S. aureus and act as potential probiotics for AD skin. 

Reports suggest the involvement of numerous microbes in modulating host response via communicating with keratinocytes, specialized immune cells and adipocytes to improve skin health and barrier function. This increased understanding of bioactive skin microbiota has discovered new biotherapeutic approaches that target the skin surface microenvironment for AD treatment.

Source: Koh LF, Ong RY, Common JE. Skin microbiome of atopic dermatitis. Allergol Int. 2022;71(1):31-9.