The Microbiome

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Dermatology and our patients have benefited greatly from scientific advances over the past decades. Advances in our understanding of immunology have made great strides toward being able to manipulate immune function, treat cancer, and control devastating
inflammatory diseases.

Primed to make another great leap forward is our understanding of the microbiome. The rich diversity of the microbes with which we travel almost certainly plays an enormous role in our health and disease. Understanding and manipulating the rich microbial diversity on our skin surface and in our gut offers the promise of new, safer treatments and perhaps even cures for chronic skin disease.

But so far, despite the promise, hype, and attractive science, despite knowing that we are covered with microbes inside and out, microbe manipulation-based treatments for skin disease, as I understand it, have been hit or miss. However, this field is changing fast. I did not think I would see in my lifetime another quantum leap forward in psoriasis care after etanercept, and I was totally wrong about that. Will the microbiome be the next fer- tile ground for new treatment? I am excited to see this month’s lead article, “Dermatology Disruptors: Next-Generation Skin Microbiome Testing and Bacteriophage Therapy.”