The effect of topical agent containing ectoin on skin microbiome in atopic dermatitis

Abstract

Aim: to assess the effect of "Perfectoin" cream containing 7% ectoin on clinical symptoms of atopic dermatitis (AD) as well as taxonomic diversity and count of skin colonizers in AD patients. Patients and Methods: this study was performed in August-November 2019 in Moscow. 30 patients with AD aged 16-45 years were enrolled. Patients were examined by allergist before and after 1-week treatment with "Perfectoin" cream (general examination, sampling the skin microbiome). The severity of skin lesions was graded using the EASI (Eczema Area and Severity Index) scoring system. MALDI-Tof mass spectrometry was applied to identify species and to count skin microbiome. Results: in AD patients, skin microbiome is characterized by taxonomic diversity being represented by microorganisms with various ecological characteristics. "Perfectoin" has different effects on them. All microorganisms were divided into three groups based on this effect. In group 1, microbial count has reduced (31 out of 53 species, 59%). In group 2, microbial count has increased (16 out of 53 species, 30%). In group 3, microbial count has not changed (6 out of 53 species, 11%). "Perfectoin" has improved skin redness, intensity of skin inflammation (skin thickening, papules/edema), and scratching. As a result, the scores of the severity and intensity of local inflammation have reduced. Conclusion: the effect of "Perfectoin" on skin microbiome in AD patients is different. The count of almost 60% of microbial species has significantly reduced after 1-week treatment. The count of other microorganisms (about 40%) has not changed or increased. These microorganisms are probably not involved in AD pathogenesis or have a positive impact on AD course (S. hominis, S. epidermidis), e.g., by controlling S. aureus count.