High α-diversity of skin microbiome and mycobiome in Japanese patients with vitiligo.

BACKGROUND: Vitiligo is an acquired pigmentary disorder characterized by depigmented patches on the skin that majorly impact patients' quality of life. Although its etiology involves genetic and environmental factors, the role of microorganisms as environmental factors in vitiligo pathology remains under-researched. OBJECTIVES: Our study explored the presence of characteristic bacterial and fungal flora in vitiligo-affected skin and investigated their potential roles in vitiligo pathogenesis. METHODS: We sequenced bacterial 16S rRNA and the fungal ITS1 region from skin swabs collected at frequently affected sites, namely the forehead and back, of patients with vitiligo. We analyzed bacterial and fungal flora in lesional and non-lesional areas of patients with vitiligo compared with corresponding sites in age- and sex-matched healthy subjects. RESULTS: Our findings revealed elevated α-diversity in both bacterial and fungal flora within vitiligo lesions compared with healthy controls. Notably, bacterial flora exhibited a distinctive composition in patients with vitiligo, and the proportional representation of Enterococcus was inversely correlated with the degree of vitiligo progression. Gammaproteobacteria, Staphylococcus spp., and Corynebacterium spp. were more abundant in vitiligo patients, with notable Staphylococcus spp. prevalence during the stable phase on the forehead. Conversely, the proportion of Malassezia sympodialis was lower and that of Malassezia globosa was higher in the progressive phase on the back of vitiligo patients. CONCLUSION: Our study identified some characteristic bacterial and fungal groups associated with vitiligo activity and prognosis, highlighting the potential roles of microorganisms in pathogenesis and offering insights into personalized disease-management approaches.

Microbiota composition of the dorsal patch of reproductive male Leptonycteris yerbabuenae.

Bacteria and other types of microbes interact with their hosts in several ways, including metabolic pathways, development, and complex behavioral processes such as mate recognition. During the mating season, adult males of the lesser long-nosed agave pollinator bat Leptonycteris yerbabuenae (Phyllostomidae: Glossophaginae) develop a structure called the dorsal patch, which is located in the interscapular region and may play a role in kin recognition and mate selection. Using high-throughput sequencing of the V4 region of the 16S rRNA gene, we identified a total of 2,847 microbial phylotypes in the dorsal patches of eleven specimens. Twenty-six phylotypes were shared among all the patches, accounting for 30 to 75% of their relative abundance. These shared bacteria are distributed among 13 families, 10 orders, 6 classes and 3 phyla. Two of these common bacterial components of the dorsal patch are Lactococcus and Streptococcus. Some of them-Helcococcus, Aggregatibacter, Enterococcus, and Corynebacteriaceae-include bacteria with pathogenic potential. Half of the shared phylotypes belong to Gallicola, Anaerococcus, Peptoniphilus, Proteus, Staphylococcus, Clostridium, and Peptostreptococcus and specialize in fatty acid production through fermentative processes. This work lays the basis for future symbiotic microbe studies focused on communication and reproduction strategies in wildlife.

Transfer of skin microbiota between two dissimilar autologous microenvironments: A pilot study.

Dysbiosis of skin microbiota is associated with several inflammatory skin conditions, including atopic dermatitis, acne, and hidradenitis suppurativa. There is a surge of interest by clinicians and the lay public to explore targeted bacteriotherapy to treat these dermatologic conditions. To date, skin microbiota transplantation studies have focused on moving single, enriched strains of bacteria to target sites rather than a whole community. In this prospective pilot study, we examined the feasibility of transferring unenriched skin microbiota communities between two anatomical sites of the same host. We enrolled four healthy volunteers (median age: 28 [range: 24, 36] years; 2 [50%] female) who underwent collection and transfer of skin microbiota from the forearm to the back unidirectionally. Using culture methods and 16S rRNA V1-V3 deep sequencing, we compared baseline and mixed ("transplant") communities, at T = 0 and T = 24 hours. Our ability to detect movement from one site to the other relied on the inherent diversity of the microenvironment of the antecubital fossa relative to the less diverse back. Comparing bacterial species present in the arm and mixed ("transplant") communities that were absent from the baseline back, we saw evidence of transfer of a partial DNA signature; our methods limit conclusions regarding the viability of transferred organisms. We conclude that unenriched transfer of whole cutaneous microbiota is challenging, but our simple technique, intended to move viable skin organisms from one site to another, is worthy of further investigation.

Inflammatory skin is associated with changes in the skin microbiota composition on the back of severe acne patients.

Acne is the most common inflammatory skin disease, affecting up to 85% of the 11-30 years old world population. Skin microbiota appears as a key player involved in several skin dermatoses physiopathology. Here, we show that inflammatory skin is associated with changes in the skin microbiota composition on the back of severe acne patients but also on the face of patients where acne was scored as mild to moderate, comparing with healthy controls. Changes were observed particularly on skin commensals Propionibacteriaceae, Staphylococcaceae and Enterococcaceae families, suggesting the importance of the balance between skin commensals to maintain skin homeostasis and control skin inflammatory process.

Chromoblastomycosis as an endemic disease in temperate Europe: first confirmed case and review of the literature.

This study reports a case of a 56-year-old white male, retired coal-miner, diagnosed with chromoblastomycosis lasting 20 years. The infection site was the burnt skin of the back. For many years the patient had not undertaken any treatment believing that the lesion had been a burn scar. A gradual increase in lesion size prompted the patient to start therapy. The diagnosis was made by histopathological examination and mycological culture. Identification of the causative agent at the species level was achieved by sequence analysis of the internal transcribed spacer (ITS) region and D1/D2 domains of the 26S rDNA. To our knowledge, this is the first documented case of chromoblastomycosis caused by Fonsecaea monophora in temperate Europe, outside the endemic area for the disease. This finding is highly significant for understanding the routes of infection of chromoblastomycosis and radically revises the traditional view of the natural ecology of the etiological agents of the disease.

Cutaneous Malassezia microbiota in atopic dermatitis patients differ by gender and body part.

BACKGROUND: Malassezia is a particularly important factor in the occurrence of atopic dermatitis (AD). AIM: The aim of this study was to quantitatively clarify the Malassezia species isolated from AD patients by gender, body part and analytical method in detail. METHODS: The subjects were 20 AD males and 47 AD females. Samples were collected from lesion and nonlesion areas on the face and upper trunk of AD patients. Malassezia DNA was analyzed using a real-time PCR system. RESULTS: The cutaneous Malassezia microbiota in AD patients differed by gender, body part and analytical method. CONCLUSIONS: The present results indicate the possibility that the influence of Malassezia antigens is different according to gender and body part.

Cutaneous Malassezia microbiota of healthy subjects differ by sex, body part and season.

Malassezia is a component of normal cutaneous resident microbiota. The aim of this study was to quantitatively clarify the differences in cutaneous Malassezia microbiota in healthy subjects by sex, body part and season. Samples were collected from the forehead, cheek, upper chest and upper back of 20 healthy men and 20 healthy women (average age 32 years) in summer and winter by the swab method. Malassezia DNA was analyzed using a real-time PCR system. As a result, in sex, body parts and season, men, the upper trunk and summer showed the highest total numbers of cutaneous Malassezia species on average. There were also differences depending on the analytical method. The predominant species were M. restricta on the face of men, M. globosa and M. dermatis on the upper trunk of men, and M. globosa and M. sympodialis on the upper trunk of women. This study clarified that the cutaneous Malassezia microbiota of healthy subjects differed by sex, body part and season.

Infections due to Phialemonium species: case report and review.

Abstract Infections caused by rarely encountered fungal pathogens have increased in recent decades. The present study describes a disseminated infection caused by Phialemonium curvatum, and reviews the literature in an effort to summarize prior experiences with this unusual pathogen. The clinical and microbiological characteristics of a new case due to Phialemonium are presented. The case is analysed with 19 other which have appeared in the literature since 1986. Ten cases were sporadic infections, while the others were associated with three small outbreaks. In all but our patient the skin's natural barrier was compromised (15/20 [75%]) and immunosuppression was a factor in the majority of cases (14/20 [70%]). Dissemination was noted in 83% (5/6) of the immunocompetent patients and in 57% (8/14) of immunocompromised patients. Endocarditis was the most frequent form of infection (8/20 [40%]). Blood cultures were positive in 92% (12/13) of those with disseminated disease. The mortality rate was 54% (7/13) among those with disseminated infections, but fatal outcomes were not observed in patients receiving treatment with itraconazole, voriconazole or posaconazole. The in vitro susceptibility of Phialemonium indicated a more consistent level of activity for voriconazole and posaconazole. Although infections usually occur when there is a breakdown in the skin the skin barrier or host defences are weakened, our case points out that infections due to Phialemonium species may occur in patients without these risk factors. The most frequent form of Phialemonium infections is endovascular, often with endocarditis and positive blood cultures, associated with high mortality rates. Treatment with the new triazoles is associated with improved survival.

[Leprosy: a rare imported disease]. / Une maladie d'importation rare: la lèpre.

Although rare in occidental countries, leprosy is an endemic disease throughout the world. Physicians may encounter imported cases and thus need to be aware of this diagnosis. We here report a 41-year-old male patient from French West Indies who presented with nonspecific extensive skin lesions and a peripheral neuropathy. Skin biopsy examination led to the diagnosis of borderline lepromatous leprosy.

Absceso subcutáneo por Actinomyces radingae / Subcutaneous abscess due to Actinomyces radingae

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Opportunistic coryneform organisms--residents of human skin.

Opportunistic infections are usually caused by endogenic flora originated from physiological flora. In this context we studied coryneform bacteria recovered from deeper layers of epidermis of the forehead (278 isolates) and the back (196 isolates) of healthy men. It was observed that coryneform bacteria are in dynamic equilibrium with coagulase-negative staphylococci and they amount 4,7% of resident aerobic flora. On the base of biological and metabolic features 49 different biotypes were indicated. Biotypes of lipophilic rods were the basic part of coryneform flora existing for long period. The most frequently isolated taxa were C. jeikeium (31%), CDC group G2 (23,4%), next in order CDC group G1 (11%) and C. afermentans ssp. lipophiluni (7%). These isolates were phenotypically differentiated. Nonlipophilic species did not play significant role in creating resident flora of the skin. The significance of coryneform bacteria in opportunistic infections is growing, especially in immunocompromissed patients. Isolated lipophilic taxa belong to these taxa coryneforms which are described in literature as the main etiologic factors of opportunistic infections.

Acute fungal pustulosis on a bedridden patient's back.

We report a particular dermatophytosis due to Trichophyton rubrum. A 61-year-old woman presented an eruption which quickly evolved within 48 h, consisting of papular annular patches surrounded by creamy white pustules, which sometimes coalesced. The eruption was exclusively located on the back. The rest of the body and skin examination was normal, and the patient had no temperature. The mycological sample revealed mycelial filaments in the direct microscopic examination and T. rubrum in the mycological culture. Only a few cases of pustular lesions due to T. rubrum are reported in the literature. The extensive character, the site and the inflammatory aspect of the lesions were very surprising. This clinical presentation is more frequent with geophilic and zoophilic organisms than with anthropophilic dermatophytes such as T. rubrum.

Differentiation of three biotypes of Malassezia species on human normal skin. correspondence with M. globosa, M. sympodialis and M. restricta.

One hundred and twenty lipid dependent Malassezia spp. isolates were obtained from the clinically normal skin of 38 healthy adult volunteers by swabbing three different body sites (back, chest and scalp). Ninety-six percent of these strains could be grouped into three biotypes on the basis of microscopic, cultural, metabolic and biochemical (catalase, esculin and lipase (C-14)) characteristics. The differential features were simple to determine and easily reproduced. Moreover, the three biotypes were referable to the species M. globosa (biotype 1), M. sympodialis (biotype 2) and M. restricta (biotype 3). Based on their microscopic features, cultural properties and body site locations, we suggest that biotype 1 /M. globosa corresponds to the description of Pityrosporum orbiculare (round yeast cells with a narrow base, very frequently found on the upper trunk), and biotype 3/M. restricta corresponds to the concept of P. ovale (oval yeast cells with a broad budding base, located mainly on the scalp). Pleomorphic biotype 2/M. sympodialis, most frequently found in the back, does not clearly fit into any of the Pityrosporum species.

Quantification of bacteria in isolated pilosebaceous follicles in normal skin.

A technique for quantitating bacteria in isolated pilosebaceous follicles is described. This involves microdissection of the follicles from biopsies of skin, using the method of chemical pretreatment of skin to facilitate the separation of the epidermis and epidermal appendages from the dermis. The aerobic cocci and anaerobic diphtheroids in pilosebaceous follicles in 66 biopsies of scalp and 48 biopsies of skin of the upper back were quantitated using this technique. On the back, aerobic staphylococci were very sparse in normal follicles, indicating that their primary habitat on the skin must be on the skin surface rather than within follicles. Of 138 isolated follicles from skin of the upper back, 94 contained no aerobic cocci. Anaerobic organisms were present in high numbers within normal follicles. The geometric mean density of anaerobes in 138 isolated follicles from skin of the upper back was 3.8 X 10(4) diphtheroids per follicle. Eighty-eight follicles contained more than 10(4) anaerobic diphtheroids. Using data from scalp biopsies we found that there was a correlation between the weight of sebaceous glands and the density of anaerobes within the follicles attached to these glands (coefficient of correlation = 0.6).

The localization and distribution of gram-positive cocci in normal skin and in lesions of acne vulgaris.

The localization of gram-positive cocci in the normal skin and in the lesions of acne vulgaris was investigated using fluorescein-labeled antiserum raised to gram-positive, coagulase-negative cocci. The cocci were found in 10 of 19 specimens from normal facial skin and in 3 of 11 specimens from the normal skin of the rest of the body. The bacteria were found mostly in the openings of follicles, but in 6 of 10 facial skin specimens, they were also present deeply in the lumina of the dilated sebaceous follicles near the sebaceous glands. Cocci were found in 5 of 6 noninflammatory acne comedones. In inflammatory acne they were demonstrated not only in the follicular canals but also sparsely in the infiltrate surrounding the follicles.