Skin Dysbiosis in Atopic Dermatitis and Psoriasis
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The skin is a complex ecosystem containing bacteria, fungi and viruses that play a role in maintaining homeostasis, protecting against pathogens and immune training. A disruption of this balance that is, skin dysbiosis is increasingly recognised as a significant factor in inflammatory skin diseases, including atopic dermatitis (AD) and psoriasis. This review includes 20 sources from the studies and reviews published between 2017 and 2026, focusing on the skin microbiome, mycobiome, the skin–gut axis, and microbiome-targeted interventions for AD and psoriasis.
[1] R. D. Bjerre, J. Bandier, L. Skov, L. Engstrand, and J. D. Johansen, “The role of the skin microbiome in atopic dermatitis: A systematic review,” Br. J. Dermatol., vol. 177, no. 5, pp. 1272–1278, 2017, doi: 10.1111/bjd.15390.
[2] L. Bonzano, F. Borgia, R. Casella, A. Miniello, E. Nettis, and S. Gangemi, “Microbiota and IL-33/31 axis linkage: Implications and therapeutic perspectives in atopic dermatitis and psoriasis,” Biomolecules, vol. 13, no. 7, Art. no. 1100, 2023, doi: 10.3390/biom13071100.
[3] S. Carmona-Cruz, L. Orozco-Covarrubias, and M. Sáez-de-Ocariz, “The human skin microbiome in selected cutaneous diseases,” Front. Cell. Infect. Microbiol., vol. 12, Art. no. 834135, 2022, doi: 10.3389/fcimb.2022.834135.
[4] H.-W. Chang, D. Yan, R. K. Singh, J. Liu, X. Lu, D. Uçmak, K. M. Lee, L. Afifi, D. Fadrosh, J. M. Leech, K. S. Vasquez, M. Lowe, M. D. Rosenblum, T. Scharschmidt, S. Lynch, and W. Liao, “Alteration of the cutaneous microbiome in psoriasis and potential role in Th17 polarization,” Microbiome, vol. 6, no. 1, Art. no. 154, 2018, doi: 10.1186/s40168-018-0533-1.
[5] Y. Chen, C. Peng, L. Zhu, J. Wang, Q. Cao, X. Chen, and J. Li, “Atopic dermatitis and psoriasis: Similarities and differences in metabolism and microbiome,” Clin. Rev. Allergy Immunol., vol. 66, no. 3, pp. 294–315, 2024, doi: 10.1007/s12016-024-08995-3.
[6] B. De Pessemier, L. Grine, M. Debaere, A. Maes, B. Paetzold, and C. Callewaert, “Gut–skin axis: Current knowledge of the interrelationship between microbial dysbiosis and skin conditions,” Microorganisms, vol. 9, no. 2, Art. no. 353, 2021, doi: 10.3390/microorganisms9020353.
[7] A.-L. Demessant-Flavigny, S. Connétable, D. Kerob, M. Moreau, L. Aguilar, and A. Wollenberg, “Skin microbiome dysbiosis and the role of Staphylococcus aureus in atopic dermatitis in adults and children: A narrative review,” J. Eur. Acad. Dermatol. Venereol., vol. 37, suppl. 5, pp. 3–17, 2023, doi: 10.1111/jdv.19125.
[8] R. Fölster-Holst, “The role of the skin microbiome in atopic dermatitis—Correlations and consequences,” J. Dtsch. Dermatol. Ges., vol. 20, no. 5, pp. 571–577, 2022, doi: 10.1111/ddg.14709.
[9] N. Fyhrquist, G. Muirhead, S. Prast-Nielsen, M. Jeanmougin, P. Olah, T. Skoog, G. Jules-Clement, M. Feld, M. Barrientos-Somarribas, H. Sinkko, E. H. van den Bogaard, P. L. J. M. Zeeuwen, G. Rikken, J. Schalkwijk, H. Niehues, W. Däubener, S. K. Eller, H. Alexander, D. Pennino, S. Suomela, I. Tessas, E. Lybeck, A. M. Baran, H. Darban, R. S. Gangwar, U. Gerstel, K. Jahn, P. Karisola, L. Yan, B. Hansmann, S. Katayama, S. Meller, M. Bylesjö, P. Hupé, F. Levi-Schaffer, D. Greco, A. Ranki, J. M. Schröder, J. Barker, J. Kere, S. Tsoka, A. Lauerma, V. Soumelis, F. O. Nestle, B. Homey, B. Andersson, and H. Alenius, “Microbe-host interplay in atopic dermatitis and psoriasis,” Nat. Commun., vol. 10, no. 1, Art. no. 4703, 2019, doi: 10.1038/s41467-019-12253-y.
[10] C. Hülpüsch, R. Rohayem, M. Reiger, and C. Traidl-Hoffmann, “Exploring the skin microbiome in atopic dermatitis pathogenesis and disease modification,” J. Allergy Clin. Immunol., vol. 154, no. 1, pp. 31–41, 2024, doi: 10.1016/j.jaci.2024.04.029.
[11] L. F. Koh, R.-Y. Ong, and J. E. Common, “Skin microbiome of atopic dermatitis,” Allergol. Int., vol. 71, no. 1, pp. 31–39, 2022, doi: 10.1016/j.alit.2021.11.001.
[12] M. Mazur, H. Tomczak, M. Lodyga, R. Czajkowski, R. Żaba, and Z. Adamski, “The microbiome of the human skin and its variability in psoriasis and atopic dermatitis,” Adv. Dermatol. Allergol., vol. 38, no. 2, pp. 205–209, 2021, doi: 10.5114/ada.2021.106197.
[13] H. Okamoto and Y. Nakamura, “Dysbiosis in the pathogenesis of atopic dermatitis,” J. Dermatol., vol. 53, no. 3, pp. 388–398, 2026, doi: 10.1111/1346-8138.70191.
[14] H. Okamoto, S. Li, and Y. Nakamura, “The role of skin dysbiosis and quorum sensing in atopic dermatitis,” JID Innov., vol. 5, no. 4, Art. no. 100377, 2025, doi: 10.1016/j.xjidi.2025.100377. The publisher/PubMed records confirm the three authors, volume 5, issue 4, article 100377, and DOI.
[15] T. Rong, R. Li, and R. Wang, “Dysbiosis of skin mycobiome in atopic dermatitis,” Mycoses, vol. 65, no. 3, pp. 285–293, 2022, doi: 10.1111/myc.13402.
[16] A. Rušanac, Z. Škibola, M. Matijašić, H. Č. Paljetak, and M. Perić, “Microbiome-based products: Therapeutic potential for inflammatory skin diseases,” Int. J. Mol. Sci., vol. 26, no. 14, Art. no. 6745, 2025, doi: 10.3390/ijms26146745. The publisher record confirms the five-author list, volume 26, issue 14, article 6745, and publication date of July 14, 2025.
[17] M. F. Sanchez-Lopez, P. A. Barrero-Caicedo, H. M. Olmos-Carval, A. F. Torres-Medina, and J. P. Alzate-Granados, “Relationship between skin and gut microbiota dysbiosis and inflammatory skin diseases in adult patients: A systematic review,” The Microbe, vol. 7, Art. no. 100342, 2025, doi: 10.1016/j.microb.2025.100342.
[18] B. Schmid, A. Künstner, A. Fähnrich, E. Bersuch, P. Schmid-Grendelmeier, H. Busch, M. Glatz, and P. P. Bosshard, “Dysbiosis of skin microbiota with increased fungal diversity is associated with severity of disease in atopic dermatitis,” J. Eur. Acad. Dermatol. Venereol., vol. 36, no. 10, pp. 1811–1819, 2022, doi: 10.1111/jdv.18347.
[19] N. E. van Hout, G. Nevot, P. A. M. Jansen, A. A. Mannan, P. L. J. M. Zeeuwen, D. J. Hijnen, R. J. Tanaka, M. Güell, and E. H. van den Bogaard, “From prebiotics to engineered microbes: Microbe-inspired treatments for atopic dermatitis,” Br. J. Dermatol., vol. 194, no. 3, pp. 420–428, 2026, doi: 10.1093/bjd/ljaf451.
[20] X.-E. Zhang, P. Zheng, S.-Z. Ye, X. Ma, E. Liu, Y.-B. Pang, Q.-Y. He, Y.-X. Zhang, W.-Q. Li, J.-H. Zeng, and J. Guo, “Microbiome: Role in inflammatory skin diseases,” J. Inflamm. Res., vol. 17, pp. 1057–1082, 2024, doi: 10.2147/JIR.S441100.
