Dysbiosis of skin mycobiome in atopic dermatitis

Atopic dermatitis (AD) is one of the most prevalent chronic inflammatory diseases. Head and neck (H&N) involvement, also known as the picture-frame pattern, can be a diagnostic and even therapeutic challenge. Sensitization to the fungus Malassezia furfur seems to be implicated in this clinical presentation. To investigate the role of Malassezia furfur in H&N dermatitis, we performed an observational single-centre study. Serum-specific IgE levels for Malassezia furfur were determined in a total of 25 patients with AD (15 receiving dupilumab treatment, 10 not receiving dupilumab), 14 patients with seborrheic dermatitis, and 19 healthy controls. Reactivity to Malassezia Furfur, in terms of serum-specific IgE levels (>0.35 Ku.arb./L), was found in 80% of patients with AD. Risk factors to consider include high total IgE levels, sensitization to multiple pneumoallergens, and elevated LDH and CRP levels. Prescription of topical antifungals, oral antifungals, or a combination of both showed good response in 100% of cases in the H&N AD group treated with dupilumab. The most appropriate treatment seems to be the use of oral itraconazole and/or ketoconazole cream. The median treatment time was 3 weeks. Localized dermatitis in H&N significantly affects the patient’s life. We present a study of sensitization to Malassezia furfur in patients with H&N AD. It is important to know the differential diagnosis and to approach the study correctly. Sensitization to Malassezia furfur may be one of the main reasons, especially in patients being treated with dupilumab. The use of antifungals allows for adequate control, avoiding treatment changes and improving the patient’s quality of life.

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“…These include the fungal family Malassezia spp. [8,9]. These lipophilic fungi require an alkaline pH for growth.…”

Section: Discussionmentioning

confidence: 99%

Study of Hypersensitivity to Malassezia furfur in Patients with Atopic Dermatitis with Head and Neck Pattern: Is It Useful as a Biomarker and Therapeutic Indicator in These Patients?

Navarro‐Triviño

Ayén‐Rodríguez

2022

Life

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“…Antifungal immune system responses include C-type lectin receptors, IL-1β, and inflammasomes [ 59 ]. In atopic dermatitis skin lesions, it has been found that Malassezia levels are decreased, and filamentous fungi are increased, along with a positive correlation between Candida and Staphylococcus [ 60 ]. Understanding and elucidating mycobiome implications of this nature could help in the development of more effective treatments for the ailments [ 58 ].…”

Section: Mycobiome Dysbiosismentioning

confidence: 99%

The Role of the Mycobiome in Women’s Health

Esposito

Patsakos

Borruso

2023

JoF

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Although the human bacteriome and virome have gained a great deal of attention over the years, the human mycobiome has been far more neglected despite having significant value and implications in human health. In women, mycobiome profiles in breastmilk, vaginal regions, the gut, skin, and the oral cavity can provide insight into women’s health, diseases, and microbiome dysbiosis. Analyses of mycobiome composition under factors, such as health, age, diet, weight, and drug exposure (including antibiotic therapies), help to elucidate the various roles of women’s mycobiome in homeostasis, microbiome interactions (synergistic and antagonistic), and health. This review summarizes the most recent updates to mycobiome knowledge in these critical areas.

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“…25,102 Dysbiosis of the skin microbiota is associated with skin disorders such as AD. Lesional skin of AD patients features increased diversity in the mycobiome with a concomitant decrease in the abundance of Malassezia spp., 31,103 as well as a dominance of Staphylococcus aureus 104,105 in the bacterial compartment. S. aureus is widely accepted as a driver of disease pathogenesis in AD.…”

Section: Microbial Interactions In the Skin Shaping Cutaneous Patholo...mentioning

confidence: 99%

New insights into immunity to skin fungi shape our understanding of health and disease

Ruchti

LeibundGut‐Landmann

2022

Parasite Immunology

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Fungi represent an integral part of the skin microbiota. Their complex interaction network with the host shapes protective immunity during homeostasis. If host defences are breached, skin-resident fungi including Malassezia and Candida, and environmental fungi such as dermatophytes can cause cutaneous infections. In addition, fungi are associated with diverse non-infectious skin disorders. Despite their multiple roles in health and disease, fungi remain elusive and understudied, and the mechanisms underlying the emergence of pathological conditions linked to fungi are largely unclear. The identification of IL-17 as an important antifungal effector mechanism represents a milestone for understanding homeostatic antifungal immunity. At the same time, host-adverse, disease-promoting roles of IL-17 have been delineated, as in psoriasis. Fungal dysbiosis represents another feature of many pathological skin conditions with an unknown causal link of intra-and interkingdom interactions to disease pathogenesis. The emergence of new fungal pathogens such as Candida auris highlights the need for more research into fungal immunology to understand how antifungal responses shape health and diseases. Recent technological advances for genetically manipulating fungi to target immunomodulatory fungal determinants, multi-omics approaches for studying immune cells in the human skin, an

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Dysbiosis of skin mycobiome in atopic dermatitis

Cited by 20 publications

References 57 publications

Study of Hypersensitivity to Malassezia furfur in Patients with Atopic Dermatitis with Head and Neck Pattern: Is It Useful as a Biomarker and Therapeutic Indicator in These Patients?

Study of Hypersensitivity to Malassezia furfur in Patients with Atopic Dermatitis with Head and Neck Pattern: Is It Useful as a Biomarker and Therapeutic Indicator in These Patients?

The Role of the Mycobiome in Women’s Health

New insights into immunity to skin fungi shape our understanding of health and disease

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