Background Acne vulgaris (acne) and cutaneous resident microorganisms are considered to be closely related. However, the bacterial and fungal microbiota in the comedonal contents of inflammatory acne lesions have not yet been investigated in detail. Purpose To clarify the relationship between cutaneous microorganisms and acne, we examined the microbiome in the comedonal contents of inflammatory acne and on the facial skin of patients with acne using 16s rRNA and ITS gene sequencing with a next-generation sequencer (NGS). Patients and Methods Twenty-two untreated Japanese acne outpatients were examined. The comedonal contents of inflammatory acne lesions on the face were collected using a comedo extractor. Skin surface samples from facial skin were collected using the swab method. Results The results obtained revealed that the predominant bacteria in the comedonal contents of inflammatory acne were Cutibacterium spp. (more prominent in areas with large amounts of sebum), while those on the skin surface were Staphylococcus spp. Malassezia spp., particularly Malassezia restricta , were the predominant fungi in both the comedonal contents of inflammatory acne and on the skin surface. The bacterial microbiome in comedonal contents exhibited stronger metabolic activity, including the production of enzymes related to acne, than that on the skin surface. Conclusion These results indicate that acne is an inflammatory disease involving the overgrowth of Cutibacterium acnes and other cutaneous resident microorganisms, including Malassezia spp.

Aim: This study describes the practices and challenges of disaster nursing experienced by Japanese nurses who were sent to Nepal soon after the 2015 earthquake. Methods: Semi-structured interviews were conducted with 12 nurses (eight women), with a mean age of 38.6 years (SD 7.3 years). The interview content was analyzed qualitatively and descriptively using content analysis. Results: Disaster nursing in Nepal included special content due to differences in the disaster sites, environment, and languages. The targets for nursing practices were victims, team members, local medical institutions and support groups, and the local staff in Nepal. Nurses experienced challenges in providing appropriate care related to the local background, communicating with local patients and staff from other countries, and collaborating as a team. Nurses lacked information about local infections; the knowledge level and educational background of local midwives and nurses; the literacy rate; and social characteristics including the caste system, culture, and rules related to health care. Participants also experienced challenges using certain materials due to the high temperature and humid climate (e.g., wound dressings); however, they developed suitable substitutes. Some nurses had difficulty using Fahrenheit thermometers, as they were unfamiliar with the measurement system. Further, the management of heat stroke, infection, and food allergies was necessary. Conclusions: Major challenges for the Japanese nurses were the shortage of knowledge and skills related to the local background, communication, and team collaboration. These skills should be emphasized in training before deployment, and in basic disaster nursing education.

Objective: The present study investigated the relationship between the skin bacterial and fungal microbiomes and skin pH at sebaceous sites, namely, the forehead, cheek and upper chest. We also examined the relationship between the skin microbiome and transepidermal water loss (TEWL), which is an indicator of rough skin.Methods: Thirty healthy Japanese subjects (15 females and 15 males) were enrolled as subjects. The forehead, cheek and upper chest were examined in August (summer) and February (winter). Skin surface samples were collected using the swab method, and the 16s rRNA and ITS regions were analysed using nextgeneration sequencing. Skin pH and TEWL were also assessed. Results:The changes observed in the skin microbiome were associated with season-dependent changes in skin pH. An increase in skin pH at the forehead and cheek was associated with a higher relative abundance of Cutibacterium spp., a reduction in bacterial diversity, and a lower relative abundance of Staphylococcus spp. A decrease in skin pH at the upper chest was associated with a higher relative abundance of Malassezia restricta, a lower relative abundance of M. sympodialis and decrease in fungal diversity. Moreover, these changes were also associated with an increase in TEWL. Conclusion:The present results indicate that changes in skin pH are associated with changes in the skin bacterial and fungal microbiomes at sebaceous sites. The changes observed in the skin microbiome were also associated with rough skin.

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