#Peter lio dermatology skin#
What questions remain about the relationship between the skin microbiome and eczema?ĭr. Thus, it follows that there are very likely to be microbiome abnormalities in newborn eczema, and perhaps if righted early enough, the disease could be halted. We also know that skin barrier dysfunction is an important independent risk factor for developing AD, such as filaggrin mutation and consequent filaggrin deficiency. We know that gut microbial diversity in the first week of life is a strong predictive factor for developing AD, and decreased diversity correlates with increased AD risk. Lio: I don’t think we really know for sure, but it certainly seems reasonable and likely. Is this something that may be altered in the skin’s microbiome early on that paves the way for newborn eczema?ĭr. I think the most timeless answer, perhaps, would be to say that a strong diversity seems to reflect a healthy microbiome and this may well trump identifying one or several species. The good bacteria are a lot more complex.
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Lio: I feel very confident in saying that Staphylococcus aureus is the bad guy here: it dominates, makes a multitude of toxins, and seems to have a verifiable effect on driving AD. There is a bit of a chicken-and-egg problem here, but I am convinced that Staph overgrowth (and loss of the erstwhile microbial diversity) can be a true cause of disease flares in some instances. For recovery, the diversity increased again with Staph correspondingly reduced, and then skin symptoms improved. In short, it suggested that as Staph became more dominant, the microbiome diversity decreased, and this led to a flare. Heidi Kong at the National Institutes of Health wrote a bold and impressive paper in 2012 that outlined this relationship between the microbiome and AD flares.
#Peter lio dermatology driver#
However, we are learning that Staph may be a primary driver of skin disease for at least some patients, and this is altering our therapeutic approach, at least on the cutting edge. It found the open, oozing skin of atopic dermatitis (AD) an apt home. In more recent history, I would say the thinking was that Staphylococcus aureus was a colonizer and an opportunist. Peter Lio, MD: We continue to learn more about this relationship at what seems like an ever-increasing pace, with numerous studies, publications, and products rapidly appearing. What do we know about the relationship between the skin microbiome and eczema? There are still more questions than answers when it comes to how the skin’s bacterial diversity affects eczema risk, but the science is evolving quickly, according to Peter Lio, MD, a Clinical Assistant Professor of Dermatology and Pediatrics at Northwestern University Feinberg School of Medicine and a member of the Board of Directors and Scientific Advisory Committee Member of the National Eczema Association. The microbiome, along with its effects on health and wellbeing, is a hot topic across many areas of medicine today, including dermatology.