Exposome and Skin: Part 1. Bibliometric Analysis and Review of the Impact of Exposome Approaches on Dermatology.

INTRODUCTION: Most skin disorders, such as atopic dermatitis, psoriasis, skin cancer or age-related skin issues, are the result of a complex interaction between genetic and environmental factors over time. As an external organ, the skin provides the opportunity to study the link between exposure to the environment and several specific biological responses using an exposome approach. The aim of this review was to identify the state of the art of exposome approaches and elucidate the impact of the new era of exposomics on dermatology. METHODS: Two parallel and independent bibliometric analyses were conducted based on documents extracted from the Core Collection and the Science Citation Index Expanded (SCI-Expanded) databases from the Clarivate Analytics' Web of Science (WOS) platform by using the following search terms "exposome" and "skin exposome". In both searches, we used the topic field that includes title, abstract, author keywords and keywords plus terms and the following filters: "English language" and all documents published up to 30 September 2021. We further analysed and interpreted documents extracted in plain text format. RESULTS: Based on the defined searches, 910 documents were identified as being related to "exposome" and 45 as being related to "skin exposome". Environmental sciences and toxicology were the most impacted research areas, and aging, cancer and respiratory allergies were the most documented diseases while, surprisingly, dermatology was much less impacted. Krutmann et al. were the pioneers in implementing this new concept in dermatology with publication of "The skin aging exposome" in 2017 (J Dermatol Sci. 2017;85:152-61). After this tipping point, the number of publications in dermatology evaluating the impact of exposome factors in many skin disorders has steadily increased. CONCLUSIONS: Exposome studies are rapidly attracting interest in dermatology. The results of these studies will undoubtedly improve our understanding of why and under which circumstances some individuals develop skin disorders and help design tailored prevention strategies for patients suffering from these disorders.