Journal
INTERNATIONAL JOURNAL OF DERMATOLOGY
Volume 60, Issue 5, Pages 589-596Publisher
WILEY
DOI: 10.1111/ijd.15308
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Funding
- American Acne and Rosacea Society
- Provost Young Investigator Fund of Johns Hopkins Department of Dermatology
- University of Maryland-School of Medicine
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Biofilm frequency was highest in comedones among acne lesions, with a significant increase in Staphylococcus abundance. The microenvironment of comedones differs from other lesions and unaffected skin, potentially contributing to the lack of host inflammatory response to these lesions.
Background The ability of Cutibacterium acnes strains to form biofilms has been correlated with their virulence. Objective This study examined biofilm and skin microbiota in acne patients in order to understand their role in the development of acne lesions. Methods Thin sections of punch biopsy specimens of (i) uninflamed comedones, (ii) inflammatory lesions, and (iii) uninvolved adjacent skin of acne patients were examined. Epiflourescence and confocal laser scanning microscopy were used for biofilm detection, and pyrosequencing with taxonomic classification of 16s rRNA gene amplicons was used for microbiota analysis. Results Of the 39 skin specimens from patients with mild-moderate acne (n = 13) that were studied, nine (23%) contained biofilm. Among these specimens, biofilm was most frequently detected in comedones (55.6%) and less frequently in inflammatory papules (22.2%) and uninvolved skin (22.2%). Comedones demonstrated the highest mean alpha diversity of all the lesion subtypes. The relative abundance of Staphylococcus was significantly higher in comedones (11.400% +/- 12.242%) compared to uninvolved skin (0.073% +/- 0.185%, P = 0.024). Conclusions The microenvironment of the comedone differs from that of inflammatory lesions and unaffected skin. The increased frequency of biofilm in comedones may account for the lack of host inflammatory response to these lesions.
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