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Review
. 2024 Oct 3;60(10):1619.
doi: 10.3390/medicina60101619.

The Contribution of the Skin Microbiome to Psoriasis Pathogenesis and Its Implications for Therapeutic Strategies

Diana Sabina Radaschin  1 , Alin Tatu  1 , Alina Viorica Iancu  2 , Cristina Beiu  3 , Liliana Gabriela Popa  3
Affiliations
Review

The Contribution of the Skin Microbiome to Psoriasis Pathogenesis and Its Implications for Therapeutic Strategies

Diana Sabina Radaschin et al. Medicina (Kaunas). .

Abstract

Psoriasis is a common chronic inflammatory skin disease, associated with significant morbidity and a considerable negative impact on the patients' quality of life. The complex pathogenesis of psoriasis is still incompletely understood. Genetic predisposition, environmental factors like smoking, alcohol consumption, psychological stress, consumption of certain drugs, and mechanical trauma, as well as specific immune dysfunctions, contribute to the onset of the disease. Mounting evidence indicate that skin dysbiosis plays a significant role in the development and exacerbation of psoriasis through loss of immune tolerance to commensal skin flora, an altered balance between Tregs and effector cells, and an excessive Th1 and Th17 polarization. While the implications of skin dysbiosis in psoriasis pathogenesis are only starting to be revealed, the progress in the characterization of the skin microbiome changes in psoriasis patients has opened a whole new avenue of research focusing on the modulation of the skin microbiome as an adjuvant treatment for psoriasis and as part of a long-term plan to prevent disease flares. The skin microbiome may also represent a valuable predictive marker of treatment response and may aid in the selection of the optimal personalized treatment. We present the current knowledge on the skin microbiome changes in psoriasis and the results of the studies that investigated the efficacy of the different skin microbiome modulation strategies in the management of psoriasis, and discuss the complex interaction between the host and skin commensal flora.

Keywords: chronic inflammatory skin disease; prebiotics; probiotics; psoriasis; skin microbiome.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Distribution of the skin commensal flora depending on local conditions.
Figure 2
Figure 2
The role of skin microbiome in skin homeostasis.
Figure 3
Figure 3
Changes in skin microbiome in psoriasis.
See this image and copyright information in PMC

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Grants and funding

The APC was funded by “Dunărea de Jos” University of Galați, Romania, VAT RO50411550.

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