# Role of Nutribiotics in Skin Care
## 4 Skin Microbiome and Dermatological Disorders
Atopic dermatitis (AD) is a chronic inflammatory skin disease affecting approximately 20% of children. In 95% of cases, AD's first manifestation appears within the first 5 years of \begin{table}
\begin{tabular}{c c c} \hline \hline
**Skin Disease or Condition** & **Microbiome Disbalance** & **Reference** \\ \hline Rosacea & _Demalex follicularum_ mites that are suspected carriers of _Bacillus oleornis_ & [PERSON] et al., 2022 [82] \\ \cline{2-3}  & Involvement of _Staphylococcus epidermidis_, _Demalex follicularum_, _Helicobacter pylori_, _Bacillus oleornis_, and _Chlamydia pneumonia_ in pathogenesis & [PERSON] et al., 2023; [PERSON] et al., 2007; [PERSON] et al., 2014; [PERSON] et al., 2020; [PERSON] et al., 2020 [95, 96, 97, 98, 99] \\ \cline{2-3}  & Higher proportions of _Firmicutes_ and _Proteobacteria_ & [PERSON] \& [PERSON], 2022 [89] \\  & Lower proportions of _Actinobacteria_ & \\ \hline Seborrheic Dermatitis & Role of _Malassezia_ & [PERSON] et al., 2016 [100] \\ \cline{2-3}  & _Actinobacter_, _Staphylococcus_, and _Streptococcus_ & [PERSON] et al., 2016 [101] \\ \cline{2-3}  & dominated the skin microbiome of lesions & \\ \cline{2-3}  & Over-colomization of _Staphylococcus epidermidis_ & [PERSON] et al., 2017 [102] \\ \cline{2-3}  & Dandruff (middle SD) increased the colonization with _Malassezia restricts_ and & [PERSON] et al., 2015 [103] \\ \cline{2-3}  & _Staphylococcus_ species & \\ \hline Hidradenitis suppurativa & _Propinibacterium_ may be part of the pathogenesis via a dysbiotic condition of the microbiota & [PERSON] et al., 2017 [104] \\ \hline Tinea pedis & Increase in fungal diversity and decrease in bacterial diversity compared to healthy controls & \\ \cline{2-3}  & Increase in _Trichenphylton rubrum_ & [PERSON] et al., 2022 [105] \\ \cline{2-3}  & Most prevalent bacteria phyla: _Firmicutes_, _Actinobacteria_, and _Proteobacteria_, _Staphylococcus_ & \\ \cline{2-3}  & (more than 30\% of the bacterial genera) & \\ \hline \hline \end{tabular}
\end{table} 
Table 1: _Cont._life, and, in 25% of the cases, AD continues into adulthood [106]. Genetic and epigenetic factors modulate AD: exposure to indoor and outdoor allergens and pollutants, nutrition, and microbiome are considered to influence and contribute to the development and severity of AD [90]. AD is characterized by an abnormal immune response; high levels of proinflammatory cytokines (e.g., IL-4, IL-13, IL-22) promote skin inflammation and contribute to barrier derangement and dysfunction. Due to inflammation, the skin may produce antimicrobial peptides (AMPs), such as defensins and cathelicidins, which can disbalance the skin microbiome [107]. AD has long been linked with _Staphylococcus aureus_ skin colonization; disease outbreaks are associated with a spread of _S. aureus_ in injured areas of the skin and a substantial loss of biodiversity in the skin microbiome. Staphylococcus exoproteins and superantigens cause inflammatory reactions in the host [90]. [PERSON] et al. [91] also reported a significant increase in colonization by _S. aureus_ and a loss of anaerobic species in AD. [PERSON] et al. [108] appointed that _S. aureus_ isolated from patients with AD also expresses higher levels of virulence factors and a propensity to develop biofilms to promote its colonization. So, therapies aim to reduce _S. aureus_ (with antimicrobials) but also aim to balance the diversity of the skin microbiome. Sporiasis is an immune-mediated inflammatory skin disease, the development of which is linked to both genetic factors and external triggers [109, 110]. However, its pathogenesis is still not fully understood, and the influence of the gut and skin microbiota is still being investigated. Sporiasis is characterized by multiple erythemat lesions with scaly plaques that arise mainly on the elbows, knees, scalp, navel, and lower back, but, in some cases, the disease spreads throughout the body in the form of erythroderma.