Supplement Article: The Role of Epidermal Barrier Dysfunction and Cutaneous Microbiome Dysbiosis in the Pathogenesis and Management of Acne Vulgaris and Rosacea

September 2022 | Volume 21 | Issue 9 | SF3502915 | Copyright © September 2022


Published online August 31, 2022

Justin W. Marson MDa, Neal Bhatia MDb, Emmy Graber MD MBAc, Julie Harper MDd, Peter Lio MDe,f, Brook Tlougan MDg,h, Dillon Nussbaum BSi, Hilary E. Baldwin MDj,k

aDepartment of Dermatology, SUNY Downstate Health Sciences University, Brooklyn, NY;
bDirector of Clinical Dermatology, Therapeutics Clinical Research, San Diego, CA;
c The Dermatology Institute of Boston, Boston, MA;
dThe Dermatology and Skin Care Center of Birmingham, Birmingham AL;
eDepartments of Dermatology & Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL;
f Medical Dermatology Associates of Chicago, Chicago, IL;
g Westmed Medical Group, Purchase, NY;
hDepartment of Dermatology, Columbia University, New York, NY;
i Department of Dermatology, George Washington University, Washington, DC;
j Acne Treatment and Research Center, Brooklyn, NY;
k Department of Dermatology, Rutgers Robert Wood Johnson Medical Center, New Brunswick, NJ



dermatitis (AD) (Figure 2).13 Despite increasing understanding in how EBD and dysbiosis may affect inflammation, therapeutic options are limited and still poorly understood.

The purpose of this paper is to review the literature regarding (1) the role that dysbiosis and EBD play in the pathogenesis of acne vulgaris (AV) and rosacea and (2) provide pearls and potential therapeutic interventions to restore CM homeostasis and EBF.

MATERIALS AND METHODS

A panel of United States (US) dermatologists recognized for their contributions and prior expertise in the diagnosis and management of AV/rosacea, and/or history of academic achievement were convened on August 4th, 2021.

Prior to meeting, a Medline literature search was performed for original studies, meta-analyses, clinical guidelines, and reviews regarding "epidermal barrier dysfunction", "epidermal barrier function", "transepidermal water loss", "cutaneous microbiome", "dysbiosis", "probiotics", "prebiotics", and "postbiotics". The Boolean term "AND" was used to find intersections between these phrases and either "acne vulgaris" or "rosacea".

Authors discussed topics including: the role of EBD and dysbiosis in AV and rosacea; the role of skin care in AV and rosacea; and agent/ingredients which may complement current standard-of-care prescription regimens.

Results of the discussion and a follow-up survey containing 8 summative statements voted on by panelists (using a 5-point Likert scale with 1 being “Strongly Disagree” and 5 being "Strongly Agree") that was performed on October 14th, 2021 are presented below.
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