A Case-Control Study of Skin Microbiome in Patients with Lamellar Ichthyosis

Abstract

Abstract Introduction: Lamellar ichthyosis is a genetic disorder of keratinization and the frequent skin infections in these patients may be a result of change in normal skin flora acting in addendum to breach in the physical barrier. Material and Methods: A comparative retrospective study was performed in patients with lamellar ichthyosis and age/ sex controlled matched patients attending the dermatology IPD/OPD with positive skin swab results from July 1st 2015 to June 31st 2016. The two groups were then compared in terms of bacterial culture results. Results: The mean gestational age of the study subjects at birth was 35.56 weeks (range: 30–39 weeks). The study sample consisted of 6 males and 3 females in LI group and 12 males and 6 females in the control group. Methicillin resistant Staphylococcusaureus (MRSA) was exclusively seen in LI patients, and Gram negative rods, Fusobacterium and Candida were found more in the LI patients than in the control group. The Bacteroidetes to Firmicutes ratio, lipophilic diphtheroids, Propionibacterium acnes, Fusobacterium and Micrococci were present more in the control group than in the LI patients. Conclusion: By knowing this microbiota, undue reliance on antibiotics can be reduced as these microorganisms may form normal commensals for the given micro environment. Furthermore, these organisms may be responsible for perpetuating the disease process by compounding the genetic keratinocyte barrier. What is known: Frequent skin infections are not uncommon in patients of lamellar ichthyosis. What is new: Methicillin resistant Staphylococcus aureus (MRSA) are commonly present in LI patients, and Gram negative rods, Fusobacterium and Candida are commoner in the LI patients than in the control group of patients.