The Human Skin Microbiome in Health and Skin Diseases

  • Huiying LiEmail author


The human skin, as the largest organ of the human body, protects the underlying tissues and plays an important role as a front-line defense system against external environmental changes and invading pathogens. It is colonized by a unique and complex microbial ecosystem, including bacteria, fungi, and bacteriophages, some of which could become pathogenic under certain circumstances. The skin microbiota is complex. Several hundred different microbial species reside on the skin. Its composition and distribution are uniquely different from the flora of other organs.


Atopic Dermatitis Atopic Dermatitis Patient Skin Site Psoriatic Lesion Seborrheic Dermatitis 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


  1. Akdis CA, Akdis M, Bieber T, Bindslev-Jensen C, Boguniewicz M, Eigenmann P, Hamid Q, Kapp A, Leung DY, Lipozencic J et al (2006) Diagnosis and treatment of atopic dermatitis in children and adults: European Academy of Allergology and Clinical Immunology/American Academy of Allergy Asthma and Immunology/PRACTALL Consensus Report. J Allergy Clin Immunol 118:152–169PubMedCrossRefGoogle Scholar
  2. Baker BS (2006) The role of microorganisms in atopic dermatitis. Clin Exp Immunol 144:1–9PubMedCentralPubMedCrossRefGoogle Scholar
  3. Bataille V, Snieder H, MacGregor AJ, Sasieni P, Spector TD (2002) The influence of genetics and environmental factors in the pathogenesis of acne: a twin study of acne in women. J Invest Dermatol 119:1317–1322PubMedCrossRefGoogle Scholar
  4. Bieber T (2008) Atopic dermatitis. N Engl J Med 358:1483–1494PubMedCrossRefGoogle Scholar
  5. Bojar RA, Holland KT (2004) Acne and Propionibacterium acnes. Clin Dermatol 22:375–379PubMedCrossRefGoogle Scholar
  6. Bruggemann H, Henne A, Hoster F, Liesegang H, Wiezer A, Strittmatter A, Hujer S, Durre P, Gottschalk G (2004) The complete genome sequence of Propionibacterium acnes, a commensal of human skin. Science 305:671–673PubMedCrossRefGoogle Scholar
  7. Capon F, Bijlmakers MJ, Wolf N, Quaranta M, Huffmeier U, Allen M, Timms K, Abkevich V, Gutin A, Smith R et al (2008) Identification of ZNF313/RNF114 as a novel psoriasis susceptibility gene. Hum Mol Genet 17:1938–1945PubMedCentralPubMedCrossRefGoogle Scholar
  8. Capon F, Di Meglio P, Szaub J, Prescott NJ, Dunster C, Baumber L, Timms K, Gutin A, Abkevic V, Burden AD et al (2007) Sequence variants in the genes for the interleukin-23 receptor (IL23R) and its ligand (IL12B) confer protection against psoriasis. Hum Genet 122:201–206PubMedCrossRefGoogle Scholar
  9. Cargill M, Schrodi SJ, Chang M, Garcia VE, Brandon R, Callis KP, Matsunami N, Ardlie KG, Civello D, Catanese JJ et al (2007) A large-scale genetic association study confirms IL12B and leads to the identification of IL23R as psoriasis-risk genes. Am J Hum Genet 80:273–290PubMedCentralPubMedCrossRefGoogle Scholar
  10. Choi J, Koo JY (2003) Quality of life issues in psoriasis. J Am Acad Dermatol 49:S57–61PubMedCrossRefGoogle Scholar
  11. Cibula D, Hill M, Vohradnikova O, Kuzel D, Fanta M, Zivny J (2000) The role of androgens in determining acne severity in adult women. Br J Dermatol 143:399–404PubMedCrossRefGoogle Scholar
  12. Cogen AL, Nizet V, Gallo RL (2008) Skin microbiota: a source of disease or defence? Br J Dermatol 158:442–455PubMedCentralPubMedCrossRefGoogle Scholar
  13. Cookson W (2004) The immunogenetics of asthma and eczema: a new focus on the epithelium. Nat Rev Immunol 4;978–988PubMedCrossRefGoogle Scholar
  14. Costello EK, Lauber CL, Hamady M, Fierer N, Gordon JI, Knight R (2009) Bacterial community variation in human body habitats across space and time. Science 326:1694–1697PubMedCentralPubMedCrossRefGoogle Scholar
  15. Crespo-Erchiga V, Florencio VD (2006) Malassezia yeasts and pityriasis versicolor. Curr Opin Infect Dis 19;139–147PubMedCrossRefGoogle Scholar
  16. Cummins CS (1976) Identification of Propionibacterium acnes and related organisms by precipitin tests with trichloroacetic acid extracts. J Clin Microbiol 2:104–110PubMedGoogle Scholar
  17. Cunliffe WJ (2002) Looking back to the future – acne. Dermatology 204:167–172PubMedCrossRefGoogle Scholar
  18. Cunliffe WJ, Holland DB, Clark SM, Stables GI (2000) Comedogenesis: some new aetiological, clinical and therapeutic strategies. Br J Dermatol 142:1084–1091PubMedCrossRefGoogle Scholar
  19. Dahl MG, McGibbon DH (1979) Complement C3 and immunoglobulin in inflammatory acne vulgaris. Br J Dermatol 101:633–640PubMedCrossRefGoogle Scholar
  20. Darley CR, Moore JW, Besser GM, Munro DD, Edwards CR, Rees LH, Kirby JD (1984) Androgen status in women with late onset or persistent acne vulgaris. Clin Exp Dermatol 9:28–35PubMedCrossRefGoogle Scholar
  21. Dawson TL Jr (2007) Malassezia globosa and restricta: breakthrough understanding of the etiology and treatment of dandruff and seborrheic dermatitis through whole-genome analysis. J Invest Dermatol Symp Proc 12:15–19CrossRefGoogle Scholar
  22. Dekio I, Sakamoto M, Hayashi H, Amagai M, Suematsu M, Benno Y (2007) Characterization of skin microbiota in patients with atopic dermatitis and in normal subjects using 16S rRNA gene-based comprehensive analysis. J Med Microbiol 56:1675–1683PubMedCrossRefGoogle Scholar
  23. Eady EA, Cove JH, Holland KT, Cunliffe WJ (1989) Erythromycin resistant propionibacteria in antibiotic treated acne patients: association with therapeutic failure. Br J Dermatol 121:51–57PubMedCrossRefGoogle Scholar
  24. Elder JT, Bruce AT, Gudjonsson JE, Johnston A, Stuart PE, Tejasvi T, Voorhees JJ, Abecasis GR, Nair RP (2010) Molecular Dissection of Psoriasis: Integrating Genetics and Biology. J Invest Dermatol 130(5):1213–1226Google Scholar
  25. Farrar MD, Howson KM, Bojar RA, West D, Towler JC, Parry J, Pelton K, Holland KT (2007) Genome sequence and analysis of a Propionibacterium acnes bacteriophage. J Bacteriol 189:4161–4167PubMedCentralPubMedCrossRefGoogle Scholar
  26. Fierer N, Hamady M, Lauber CL, Knight R (2008) The influence of sex handedness and washing on the diversity of hand surface bacteria. Proc Natl Acad Sci USA 105:17994–17999PubMedCentralPubMedCrossRefGoogle Scholar
  27. Gao Z, Tseng CH, Pei Z, Blaser MJ (2007) Molecular analysis of human forearm superficial skin bacterial biota. Proc Natl Acad Sci USA 104:927–2932Google Scholar
  28. Gao Z, Tseng CH, Strober BE, Pei Z, Blaser MJ (2008) Substantial alterations of the cutaneous bacterial biota in psoriatic lesions. PLoS One 3:e2719PubMedCentralPubMedCrossRefGoogle Scholar
  29. Gloor M, Franke M (1978) On the propionibacteria in the pilosebaceous ducts of uninvolved skin of acne patients. Arch Dermatol Res 262:125–129PubMedCrossRefGoogle Scholar
  30. Gloor M, Peters G, Stoika D (1982) On the resident aerobic bacterial skin flora in unaffected skin of patients with atopic dermatitis and in healthy controls. Dermatologica 164:258–265PubMedCrossRefGoogle Scholar
  31. Goodacre R, Howell SA, Noble WC, Neal MJ (1996) Sub-species discrimination, using pyrolysis mass spectrometry and self-organising neural networks, of Propionibacterium acnes isolated from normal human skin. Zentralbl Bakteriol 284:501–515PubMedCrossRefGoogle Scholar
  32. Goodman H (1943) The hydrogen ion concentration of the skin. Urol Cutan Rev 47:470–477Google Scholar
  33. Gowland G, Ward RM, Holland KT, Cunliffe WJ (1978) Cellular immunity to P. acnes in the normal population and patients with acne vulgaris. Br J Dermatol 99:43–47PubMedCrossRefGoogle Scholar
  34. Grice EA, Kong HH, Conlan S, Deming CB, Davis J, Young AC, Bouffard GG, Blakesley RW, Murray PR, Green ED et al (2009) Topographical and temporal diversity of the human skin microbiome. Science 324:1190–1192PubMedCentralPubMedCrossRefGoogle Scholar
  35. Grice EA, Kong HH, Renaud G, Young AC, Bouffard GG, Blakesley RW, Wolfsberg TG, Turner ML, Segre JA (2008) A diversity profile of the human skin microbiota. Genome Res 18(7):1043–1050Google Scholar
  36. Gupta MA, Schork NJ, Gupta AK, Kirkby S, Ellis CN (1993) Suicidal ideation in psoriasis. Int J Dermatol 32:188–190PubMedCrossRefGoogle Scholar
  37. Harris WH, Wade HW (1915) The wide-spread distribution of diphtheroids and their occurrence in various lesions of human tissues. J Exp Med 21:493–508PubMedCentralPubMedCrossRefGoogle Scholar
  38. Higaki S, Kitagawa T, Kagoura M, Morohashi M, Yamagishi T (2000) Correlation between Propionibacterium acnes biotypes, lipase activity and rash degree in acne patients. J Dermatol 27:519–522PubMedGoogle Scholar
  39. Holland KT, Bojar RA (2002) Cosmetics: what is their influence on the skin microflora? Am J Clin Dermatol 3:445–449PubMedCrossRefGoogle Scholar
  40. Holmes RL, Williams M, Cunliffe WJ (1972) Pilo-sebaceous duct obstruction and acne. Br J Dermatol 87:327–332PubMedCrossRefGoogle Scholar
  41. Holt RJ (1971) Aerobic bacterial counts on human skin after bathing. J Med Microbiol 4:319–327PubMedCrossRefGoogle Scholar
  42. Jong EC, Ko HL, Pulverer G (1975) Studies on bacteriophages of Propionibacterium acnes. Med Microbiol Immunol 161:263–271PubMedCrossRefGoogle Scholar
  43. Katsambas A, Dessinioti C (2008) New and emerging treatments in dermatology: acne. Dermatol Ther 21:86–95PubMedCrossRefGoogle Scholar
  44. Kersey P, Sussman M, Dahl M (1980) Delayed skin test reactivity to Propionibacterium acnes correlates with severity of inflammation in acne vulgaris. Br J Dermatol 103:651–655PubMedCrossRefGoogle Scholar
  45. Kluytmans J, van Belkum A, Verbrugh H (1997) Nasal carriage of Staphylococcus aureus: epidemiology, underlying mechanisms, and associated risks. Clin Microbiol Rev 10:505–520PubMedCentralPubMedGoogle Scholar
  46. Krueger G, Ellis CN (2005) Psoriasis – recent advances in understanding its pathogenesis and treatment. J Am Acad Dermatol 53:S94–100PubMedCrossRefGoogle Scholar
  47. Lee DJ, Van Dyke GS, Kim J (2003) Update on pathogenesis and treatment of acne. Curr Opin Pediatr 15:405–410PubMedCrossRefGoogle Scholar
  48. Leeming JP, Holland KT, Cuncliffe WJ (1988) The microbial colonization of inflamed acne vulgaris lesions. Br J Dermatol 118:203–208PubMedCrossRefGoogle Scholar
  49. Leung DY (2003) Infection in atopic dermatitis. Curr Opin Pediatr 15:399–404PubMedCrossRefGoogle Scholar
  50. Leung DY, Bieber T (2003) Atopic dermatitis. Lancet 361:151–160PubMedCrossRefGoogle Scholar
  51. Leung DY, Boguniewicz M, Howell MD, Nomura I, Hamid QA (2004) New insights into atopic dermatitis. J Clin Invest 113:651–657PubMedCentralPubMedCrossRefGoogle Scholar
  52. Leyden JJ, McGinley KJ, Vowels B (1998) Propionibacterium acnes colonization in acne and nonacne. Dermatology 196:55–58PubMedCrossRefGoogle Scholar
  53. Lina G, Boutite F, Tristan A, Bes M, Etienne J, Vandenesch F (2003) Bacterial competition for human nasal cavity colonization: role of Staphylococcal agr alleles. Appl Environ Microbiol 69:18–23PubMedCentralPubMedCrossRefGoogle Scholar
  54. Liu PT, Phan J, Tang D, Kanchanapoomi M, Hall B, Krutzik SR, Kim J (2008a) CD209(+) macrophages mediate host defense against Propionibacterium acnes. J Immunol 180:4919–4923PubMedCrossRefGoogle Scholar
  55. Liu PT, Stenger S, Li H, Wenzel L, Tan BH, Krutzik SR, Ochoa MT, Schauber J, Wu K, Meinken C et al (2006) Toll-like receptor triggering of a vitamin D-mediated human antimicrobial response. Science 311:1770–1773PubMedCrossRefGoogle Scholar
  56. Liu Y, Helms C, Liao W, Zaba LC, Duan S, Gardner J, Wise C, Miner A, Malloy MJ, Pullinger CR et al (2008b) A genome-wide association study of psoriasis and psoriatic arthritis identifies new disease loci. PLoS Genet 4:e1000041PubMedCentralPubMedCrossRefGoogle Scholar
  57. Marples MJ (1969) The normal flora of the human skin. Br J Dermatol 81(Suppl 1):2–13PubMedCrossRefGoogle Scholar
  58. Marples RR, McGinley KJ, Mills OH (1973) Microbiology of comedones in acne vulgaris. J Invest Dermatol 60:80–83PubMedCrossRefGoogle Scholar
  59. Matousek JL, Campbell KL (2002) A comparative review of cutaneous pH Vet Dermatol 13:293–300CrossRefGoogle Scholar
  60. Nair RP, Ruether A, Stuart PE, Jenisch S, Tejasvi T, Hiremagalore R, Schreiber S, Kabelitz D, Lim HW, Voorhees JJ et al (2008) Polymorphisms of the IL12B and IL23R genes are associated with psoriasis. J Invest Dermatol 128:1653–1661PubMedCentralPubMedCrossRefGoogle Scholar
  61. Noble WC (1969) Distribution of the micrococcaceae. Br J Dermatol 81(Suppl):27–32PubMedCrossRefGoogle Scholar
  62. Norris JF, Cunliffe WJ (1988) A histological and immunocytochemical study of early acne lesions. Br J Dermatol 118:651–659PubMedCrossRefGoogle Scholar
  63. O’Regan GM, Sandilands A, McLean WH, Irvine AD (2009) Filaggrin in atopic dermatitis. J Allergy Clin Immunol 124:R2–6PubMedCrossRefGoogle Scholar
  64. Olsen TG (1982) Therapy of acne. Med Clin North Am 66:851–871PubMedGoogle Scholar
  65. Paulino LC, Tseng CH, Blaser MJ (2008) Analysis of Malassezia microbiota in healthy superficial human skin and in psoriatic lesions by multiplex real-time PCR. FEMS Yeast Res 8:460–471PubMedCrossRefGoogle Scholar
  66. Paulino LC, Tseng CH, Strober BE, Blaser MJ (2006) Molecular analysis of fungal microbiota in samples from healthy human skin and psoriatic lesions. J Clin Microbiol 44:2933–2941PubMedCentralPubMedCrossRefGoogle Scholar
  67. Plewig G, Fulton JE, Kligman AM (1971) Cellular dynamics of comedo formation in acne vulgaris. Arch Dermatol Forsch 242:12–29PubMedCrossRefGoogle Scholar
  68. Puhvel SM, Amirian D, Weintraub J, Reisner RM (1977) Lymphocyte transformation in subjects with nodulo cystic acne. Br J Dermatol 97:205–211PubMedCrossRefGoogle Scholar
  69. Rieg S, Steffen H, Seeber S, Humeny A, Kalbacher H, Dietz K, Garbe C, Schittek B (2005) Deficiency of dermcidin-derived antimicrobial peptides in sweat of patients with atopic dermatitis correlates with an impaired innate defense of human skin in vivo. J Immunol 174:8003–8010PubMedCrossRefGoogle Scholar
  70. Ro BI, Dawson TL (2005) The role of sebaceous gland activity and scalp microfloral metabolism in the etiology of seborrheic dermatitis and dandruff. J Invest Dermatol Symp Proc 10:94–197Google Scholar
  71. Rosenberg EW (1969) Bacteriology of acne. Annu Rev Med 20:201–206PubMedCrossRefGoogle Scholar
  72. Ruocco E, Donnarumma G, Baroni A, Tufano MA (2007) Bacterial and viral skin diseases. Dermatol Clin 25:663–676, xiPubMedCrossRefGoogle Scholar
  73. Sander HM, Morris LF, Phillips CM, Harrison PE, Menter A (1993) The annual cost of psoriasis. J Am Acad Dermatol 28:422–425PubMedCrossRefGoogle Scholar
  74. Shaw CM, Smith JA, McBride ME, Duncan WC (1970) An evaluation of techniques for sampling skin flora. J Invest Dermatol 54:160–163PubMedCrossRefGoogle Scholar
  75. Steiner B, Romero-Steiner S, Cruce D, George R (1997) Cloning and sequencing of the hyaluronate lyase gene from Propionibacterium acnes. Can J Microbiol 43:315–321PubMedCrossRefGoogle Scholar
  76. Strachan DP (1989) Hay fever hygiene, and household size. BMJ 299:1259–1260PubMedCentralPubMedCrossRefGoogle Scholar
  77. Strauss JS, Kligman AM (1960) The pathologic dynamics of acne vulgaris. Arch Dermatol 82:779–790CrossRefGoogle Scholar
  78. Strauss JS, Pochi PE, Downing DT (1976) The role of skin lipids in acne. Cutis 17:485–487PubMedGoogle Scholar
  79. Strauss JS, Thiboutot DM (1999) Diseases of the sebaceous glands. In Fitzpatrick’s Dermatology In: Freedberg IM, Eisen AZ, Wolff K, Austen KF, Goldsmith LA, Katz SI, Fitzpatrick TB (eds) General Medicine. McGraw-Hill, New York, NY, pp 769–784Google Scholar
  80. Terui T (2009) Analysis of the mechanism for the development of allergic skin inflammation and the application for its treatment: overview of the pathophysiology of atopic dermatitis. J Pharmacol Sci 110:232–236PubMedCrossRefGoogle Scholar
  81. Tsunemi Y, Saeki H, Nakamura K, Sekiya T, Hirai K, Fujita H, Asano N, Kishimoto M, Tanida Y, Kakinuma T et al (2002) Interleukin-12 p40 gene (IL12B) 3'-untranslated region polymorphism is associated with susceptibility to atopic dermatitis and psoriasis vulgaris. J Dermatol Sci 30:161–166PubMedCrossRefGoogle Scholar
  82. Watson W, Cann HM, Farber EM, Nall ML (1972) The genetics of psoriasis. Arch Dermatol 105:197–207PubMedCrossRefGoogle Scholar
  83. Webster GF (1995) Inflammation in acne vulgaris. J Am Acad Dermatol 33:247–253PubMedCrossRefGoogle Scholar
  84. Webster GF, Cummins CS (1978) Use of bacteriophage typing to distinguish Propionibacterium acnes types I and II. J Clin Microbiol 7:84–90PubMedCentralPubMedGoogle Scholar
  85. Wollenberg A, Zoch C, Wetzel S, Plewig G, Przybilla B (2003) Predisposing factors and clinical features of eczema herpeticum: a retrospective analysis of 100 cases. J Am Acad Dermatol 49:198–205PubMedCrossRefGoogle Scholar
  86. Zhang XJ, Huang W, Yang S, Sun LD, Zhang FY, Zhu QX, Zhang FR, Zhang C, Du WH, Pu XM et al (2009) Psoriasis genome-wide association study identifies susceptibility variants within LCE gene cluster at 1q21. Nat Genet 41:205–210PubMedCrossRefGoogle Scholar
  87. Zhang YQ, Ren SX, Li HL, Wang YX, Fu G, Yang J, Qin ZQ, Miao YG, Wang WY, Chen RS et al (2003) Genome-based analysis of virulence genes in a non-biofilm-forming Staphylococcus epidermidis strain (ATCC 12228). Mol Microbiol 49:1577–1593PubMedCrossRefGoogle Scholar
  88. Zierdt CH, Webster C, Rude WS (1968) Study of the anaerobic corynebacteria. Int J Syst Bacteriol 18:33–47CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  1. 1.Crump Institute for Molecular Imaging, California NanoSystems InstituteLos AngelesUSA

Personalised recommendations