Skin Ecology during Sebaceous Drought—How Skin Microbes Respond to Isotretinoin

Open ArchivePublished:December 19, 2018DOI:https://doi.org/10.1016/j.jid.2018.09.023
      Twenty-five percent of acne vulgaris patients are prescribed oral antibiotic courses lasting longer than 6 months (
      • Barbieri J.S.
      • James W.D.
      • Margolis D.J.
      Trends in prescribing behavior of systemic agents used in the treatment of acne among dermatologists and nondermatologists: a retrospective analysis, 2004–2013.
      ). These courses can cause significant collateral damage (dysbiosis, antibiotic resistance) (
      • Leyden J.J.
      • Del Rosso J.Q.
      • Baum E.W.
      The use of isotretinoin in the treatment of acne vulgaris: clinical considerations and future directions.
      ). Acne antibiotics target Cutibacterium (formerly Propionibacterium) acnes (
      • Scholz C.F.P.
      • Kilian M.
      The natural history of cutaneous propionibacteria, and reclassification of selected species within the genus Propionibacterium to the proposed novel genera Acidipropionibacterium gen. nov., Cutibacterium gen. nov. and Pseudopropionibacterium gen. nov.
      ). This bacterium is associated with acne and can cause opportunistic infections (
      • Achermann Y.
      • Goldstein E.J.C.
      • Coenye T.
      • Shirtliff M.E.
      Propionibacterium acnes: from commensal to opportunistic biofilm-associated implant pathogen.
      ).

      Abbreviations:

      PSU ( pilosebaceous unit), RT ( ribotype), T ( time point)

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