Journal
EXPERIMENTAL DERMATOLOGY
Volume 27, Issue 12, Pages 1372-1377Publisher
WILEY
DOI: 10.1111/exd.13791
Keywords
microbiome; palmoplantar pustulosis; sterile pustule
Categories
Funding
- JSPS KAKENHI Grant [15K10941, 16K10128]
- Grants-in-Aid for Scientific Research [15K10941, 16K10128] Funding Source: KAKEN
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The skin microbiome influences skin pathophysiology. Palmoplantar pustulosis (PPP) is a chronic skin disease characterized by infectious-like pustules on the palms and soles. These pustules are thought to be sterile because bacterial cultures obtained from the pustules are negative. However, culture methods are limited in their ability to identify all bacteria on the skin. We hypothesized that the sterile pustules of PPP do not lack bacteria, but rather contain a microbiome. To test this hypothesis, we identified bacteria in sterile pustules using non-culture methods. We conducted Sanger and 16S rRNA sequencing using primers specific to the V1-V2 region in PPP-pustulovesicles (PVs) (n = 43) and pompholyx vesicle fluids (n = 15). Sanger sequencing identified some Staphylococcus, Propionibacterium, Streptococcus and Pyrinomonas species in PPP-PVs but failed to identify any bacteria in most of the pompholyx vesicles. 16S rRNA sequencing of PPP-PVs indicated the presence of a microbiome that included various phyla, including Firmicutes, Proteobacteria, Actinobacteria and Bacteroidetes. At the genus level, smokers had higher levels of Staphylococcus in PPP-PVs compared with non-smokers. These results indicate that a microbiome exists in sterile pustules of PPP and that PPP smokers had higher levels of Staphylococcus in pustules. It is therefore necessary to reconsider the pathogenesis of PPP from the perspective of the microbiome.
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