CURRENT PERSPECTIVES ON THE ROLE OF THE CUTANEOUS MICROBIOME IN CHRONIC INFLAMMATORY SKIN DISEASES

Objective: The skin microbiome is a complex ecosystem of bacteria, viruses, fungi, and archaea that interacts with host cells to regulate defense mechanisms, immune responses, colonization resistance, and tissue repair. This review aims to summarize current knowledge on the role of the skin microbiome in the course and treatment of chronic inflammatory dermatoses, including atopic dermatitis, psoriasis, and acne vulgaris. Materials and methods: A literature review was performed using PubMed and Google Scholar databases. Keywords included: skin microbiota, skin microbiome, chronic inflammatory dermatoses, atopic dermatitis, psoriasis, acne vulgaris, microbiome transplantation, probiotics, prebiotics, and postbiotics. A total of 36 articles published between 2008 and 2024 were analyzed for relevance. Description: Patients with atopic dermatitis show reduced microbial diversity, characterized by Staphylococcus aureus overgrowth and decreased commensal bacteria such as Streptococcus, Corynebacterium, Cutibacterium, and Proteobacteria. In psoriasis, decreased levels of Corynebacterium spp., Lactobacillus spp., and Cutibacterium acnes are common. Acne vulgaris is linked to excessive sebum production, abnormal follicular keratinization, Cutibacterium acnes colonization, and inflammation. Strategies to modulate the skin microbiome include microbiome transplantation and bacteriotherapy, which applies selected beneficial strains to disinfected skin. These methods may offer more practical alternatives than full transplantation. Additionally, prebiotic compounds can promote the growth of protective microbes, while probiotics and postbiotics are increasingly studied for their therapeutic effects. Conclusions: Chronic inflammatory dermatoses significantly impair quality of life. Evidence suggests that targeting the skin microbiome holds therapeutic potential. Further studies are needed to clarify microbiota–host interactions, consequences of dysbiosis, and the clinical utility of microbiome-based interventions.