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. 2020 Feb;21(1):139-147.
doi: 10.1007/s40257-019-00471-5.

Characterization and Analysis of the Skin Microbiota in Rosacea: A Case-Control Study

Barbara M Rainer  1   2 , Katherine G Thompson  1 , Corina Antonescu  3 , Liliana Florea  3 , Emmanuel F Mongodin  4 , Jonathan Bui  4 , Alexander H Fischer  1 , Helena B Pasieka  1 , Luis A Garza  1 , Sewon Kang  1 , Anna L Chien  5
Affiliations

Characterization and Analysis of the Skin Microbiota in Rosacea: A Case-Control Study

Barbara M Rainer et al. Am J Clin Dermatol. 2020 Feb.

Abstract

Background: The efficacy of antibiotics in rosacea treatment suggests a role for microorganisms in its pathophysiology. Growing concern over the adverse effects of antibiotic use presents a need for targeted antimicrobial treatment in rosacea.

Objective: We performed a case-control study to investigate the skin microbiota in patients with rosacea compared to controls matched by age, sex, and race.

Methods: Nineteen participants with rosacea, erythematotelangiectatic, papulopustular, or both, were matched to 19 rosacea-free controls. DNA was extracted from skin swabs of the nose and bilateral cheeks of participants. Sequencing of the V3V4 region of the bacterial 16S ribosomal RNA gene was performed using Illumina MiSeq and analyzed using QIIME/MetaStats 2.0 software.

Results: Compared with controls, skin microbiota in erythematotelangiectatic rosacea was depleted in Roseomonas mucosa (p = 0.004). Papulopustular rosacea was enriched in Campylobacter ureolyticus (p = 0.001), Corynebacterium kroppenstedtii (p = 0.008), and the oral flora Prevotella intermedia (p = 0.001). The highest relative abundance of C. kroppenstedtii was observed in patients with both erythematotelangiectatic and papulopustular rosacea (19.2%), followed by papulopustular (5.06%) and erythematotelangiectatic (1.21%) rosacea. C. kroppenstedtii was also associated with more extensive disease, with the highest relative abundance in rosacea affecting both the cheeks and nose (2.82%), followed by rosacea sparing the nose (1.93%), and controls (0.19%).

Conclusions: The skin microbiota in individuals with rosacea displays changes from that of healthy skin, suggesting that further studies examining a potential role for the skin microbiota in the pathophysiology of rosacea may be warranted.

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Conflict of interest statement

Conflict of interest Anna L. Chien participated in Galderma’s Rosacea Medical Advisory Board Meeting in 2017. Sewon Kang is an advisory board member of Almirall and has received an honorarium. The participation was not in relation to the current article. Barbara M. Rainer, Katherine G. Thompson, Corina Antonescu, Liliana Florea, Emmanuel F. Mongodin, Jonathan Bui, Helena B. Pasieka, Alexander H. Fischer, and Luis A. Garza have no conflicts of interest that are directly relevant to the content of this article.

Figures

Fig. 1
Fig. 1
Taxonomy plot comparing microbial distributions of cheek (C) and nose (N) samples from healthy controls and patients with erythematotelangiectatic rosacea (ETR), papulopustular rosacea (PPR), or both at the phylum level
Fig. 2
Fig. 2
Taxonomy plot comparing microbial distributions of cheek (C) and nose (N) samples from healthy controls and patients with erythematotelangiectatic rosacea (ETR), papulopustular rosacea (PPR), or both at the species level. The legend includes only species present in the highest relative abundance
Fig. 3
Fig. 3
Alpha diversity using a phylogenic diversity whole tree metric across rosacea subtypes
Fig. 4
Fig. 4
Principal coordinates analysis depicting beta diversity of patients with rosacea (blue) vs. controls (red)
Fig. 5
Fig. 5
Relative abundance of Cutibacterium acnes by age groups in women and men
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