Atopic dermatitis is a common skin disease characterized by dry and itchy skin with eczema flares. The disease is associated with changes in the skin microbiota, which constitutes all microorganisms present on the skin surface. The greatest difference is due to increased abundance of Staphylococcus aureus, a bacterium that can cause skin infections and probably contributes to aggravation of the disease. This review aims to provide an overview of recently published literature regarding changes in the skin microflora in atopic dermatitis and its association with disease severity and exacerbation. Atopic dermatitis is a common inflammatory skin disease with a complex pathogenesis that includes imbalanced immune system signalling, impaired skin barrier and enhanced Staphylococcus aureus skin colonization. The skin bacterial communities are characterized by increasing abundance of S. aureus, leading to reduced diversity compared with the bacterial communities on healthy skin, and increasing disease severity. In contrast, fungal communities are richer and more diverse on the skin of patients with atopic dermatitis, although distribution of the most common species is similar in patients and controls. Filaggrin deficiency in atopic dermatitis skin might be related to the enhanced skin colonization by S. aureus. In addition, S. aureus expressing variant virulence factors have been shown to elicit atopic dermatitis-like phenotypes in mice, indicating that specific S. aureus strains can induce flare-ups. This review aims to provide an overview of the recent literature on the skin microbiome in atopic dermatitis.
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