Cutaneous Microbiome: The invisible ecosystem and its role in inflammatory dermatoses

The cutaneous microbiome represents a diverse and dynamic ecosystem composed of bacteria, fungi, viruses, and microscopic arthropods that inhabit the skin’s surface. Far beyond being a passive community, these microorganisms play a fundamental role in maintaining skin homeostasis, modulating immune responses, and protecting against pathogenic invasion. Advances in next-generation sequencing and metagenomic analyses have deepened our understanding of its complexity, highlighting how alterations in microbial balance—known as dysbiosis—are implicated in various inflammatory dermatoses. Exploring the interactions between the skin and its microbiome is crucial for developing innovative diagnostic and therapeutic strategies in dermatology. This literature review was conducted using scientific publications retrieved from the Virtual Health Library (VHL), PubMed, CAPES Journals Portal, and the Scientific Electronic Library Online (SciELO), with no time restrictions. The cutaneous microbiome constitutes an essential ecosystem for skin integrity, actively participating in the physical barrier, immunomodulation, and protection against pathogens. Alterations in its composition, characterized as dysbiosis, are strongly associated with inflammatory dermatoses such as atopic dermatitis, psoriasis, acne, and rosacea. Advances in sequencing and metagenomic techniques have made it possible to identify these interactions, driving the development of innovative therapies such as probiotics, prebiotics, bacteriophages, and microbial transplants. In this context, understanding and manipulating the cutaneous microbiome represents not only a scientific advance but also an opportunity to transform dermatological practice toward more personalized approaches.