Relationship Between the Acne Clinical Course and Severity and the State of Microbiota of the Skin and Large Intestine

Abstract

A high incidence of acne, tendency to its chronic course with the formation of resistance to treatment and frequent development of deep forms determine an important medical and social significance of the problem.
 Aim. To study and evaluate the degree of changes in the microbiocenosis of the skin and large intestine in patients with acne, depending on their clinical course.
 Materials and Methods. We examined 85 patients with acne, aged 18 to 45 years, 49 (57.65±5.36%) women, 36 (42.35±5.36%) men and 35 apparently healthy persons who made up the control group. The composition of microbiota of the skin and large intestine was examined using a bacteriological method.
 Results and Discussion. It was found that there is a significantly lower content of bifidobacteria and lactobacilli, bacterioids and total E. coli count in the large intestine in patients with acne associated with a higher amount of E. coli with enzyme properties, conditionally pathogenic enterobacteria, enterococci and fungi of the genus Candida. When using Friedman's non-parametric analysis of variance, it was found that there is a statistically significant difference between the frequency of detection of normocenosis and the stage of the large intestinal dysbiosis and the development of clinical forms of acne. At that, normocenosis was detected more often in patients with comedonal acne, while papular and nodular acne occurred more often in patients with manifestations of different stages of dysbiosis. An increase in seeding with associations of the alpha-hemolytic streptococcus + Staphylococcus haemolyticus + Micrococcus, beta-hemolytic streptococcus + Staphylococcus aureus + E.Coli + Candida albicans and a significant increase in the growth of alpha-hemolytic streptococcus, Staphylococcus haemoliticus and Staphylococcus aureus were found in the microbiocenosis of the skin in patients with acne. At that, all of the above microorganisms were not cultured in the patients of the control group.
 Conclusion. The qualitative and quantitative changes in the parameters of microbiocenosis of the skin and large intestine, which depend on the clinical course of dermatosis, were found in the examined patients with acne. This indicates the need for additional examination of such patients with the aim of prescribing a pathogenetically substantiated therapy.