Background Systemic alterations in the oral cavity can be reflected in skin disorders like psoriasis. However, data about oral health factors that are affected and controlled mainly by oral microbiota in atopic dermatitis (AD) are sparse. This study compared the oral status and oral microbiota of AD patients and healthy controls. Methods This was a prospective sex- and age-matched case-control study comparing adult participants with and without dermatologist-verified AD. A dentist assessed oral health status, and oral flora samples were collected and subjected to 16S rRNA sequencing for microbiome analysis. Results Forty-five AD participants and 41 non-AD controls were recruited. Compared to the participants in the control group, those with AD had significantly higher plaque levels (P = .04), poorer oral hygiene indices (P = .04), and higher gingival index trends (P = .05). The oral microbiome in the AD group showed significantly higher diversity, both in α and β diversities (P = .001, P = .0007, respectively). Furthermore, AD patients had a significantly increased abundance of taxa correlated with oral diseases and a decreased abundance of bacteria associated with a healthy oral status. Conclusion AD appears to be associated with poor oral health and oral dysbiosis. There is a need to increase both patients’ and physicians’ awareness of oral health.

Background: Hidradenitis suppurativa (HS) is a chronic skin disease characterized by inflammatory nodules and abscesses. The pathogenic role of bacteria is not fully understood. As the diagnosis is usually delayed, patients are often treated with several lines of antibiotics in a nonstandardized fashion. The aim of the study was to investigate and compare the bacteriology of active HS lesions in patients treated or not treated with antibiotics in the community setting before referral to a dedicated HS clinic. Methods: Purulent skin lesions of patients with HS referred to the HS Clinic of Rabin Medical Center in 2009–2020 were cultured. Data were collected from the patients’ medical files and microbiology reports. The correlation between the location of the skin lesion and the bacteriologic profile was analyzed, and the effects of previous antibiotic treatment on the bacteriologic profile of the lesions and susceptibility patterns of the cultured bacteria were evaluated. Results: Pus (or tissue) from inflammatory lesions of 97 patients with HS was cultured. Mean (SD) patient age was 39.5 (13.0) years, and mean delay in diagnosis was 7.3 (8.3) years. Most patients (57.7%) had dominant involvement of one location, with the most active lesions concentrated in the genitalia, gluteal/perineal area, and axilla. Enterobacterales species were the most frequent isolates detected in all locations except the face and scalp. Seventy-eight patients (80.4%) had been treated in the community setting prior to referral with a median (range) of 2 (1–8) lines of antibiotics. The most commonly prescribed antibiotics were amoxicillin/clavulanate (22.0%), doxycycline/minocycline (16.8%), clindamycin (16.2%; monotherapy 8.1%, clindamycin with rifampicin 8.1%), and cephalexin (13.9%). Compared to the previously untreated patients, cultures of lesions from the previously treated patients yielded a higher percentage of gram-negative Enterobacterales (the most common isolates in this group) (31.3% vs. 10.3%) and a significantly higher median number of isolates per culture (2 vs. 1, p < 0.0001). Gram-positive bacteria, usually considered contaminants (mainly coagulase-negative staphylococci) accounted for 31.0% of the isolates in the previously treated group. Susceptibility testing for the entire cohort revealed 100% bacterial sensitivity to ciprofloxacin. Staphylococcus spp. were 100% sensitive to rifampicin. Both gram-positive and gram-negative bacteria had high sensitivity to trimethoprim and sulfamethoxazole. Conclusion: Nonstandardized antibiotic treatment of HS in the community setting can skew the microbiology of skin lesions toward gram-negative bacteria. Therefore, treatment with trimethoprim and sulfamethoxazole or ciprofloxacin, either alone or combined with rifampicin, may be considered.

Photodermatology, Photoimmunology & PhotomedicineVolume 37, Issue 3 p. 195-197 LETTER TO THE EDITOR A case of hydroa vacciniforme in an adult patient Yossi Taieb, Yossi Taieb Photodermatosis Service and Laser Unit, Division of Dermatology, Rabin Medical Center, Petah-Tikva, Israel Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, IsraelSearch for more papers by this authorEmmilia Hodak, Emmilia Hodak Photodermatosis Service and Laser Unit, Division of Dermatology, Rabin Medical Center, Petah-Tikva, Israel Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, IsraelSearch for more papers by this authorElena Didkovsky, Elena Didkovsky Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel Department of Pathology, Rabin Medical Center, Petah-Tikva, IsraelSearch for more papers by this authorClaes David Enk, Claes David Enk Department of Dermatology, Hadassah-Hebrew University Medical Center, Jerusalem, IsraelSearch for more papers by this authorNadav Astman, Nadav Astman Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel Department of Dermatology, Sheba Medical Center, Tel-Hashomer, Israel Israel Defense Forces Medical Corps, Tel Hashomer, Ramat Gan, IsraelSearch for more papers by this authorAssi Levi, Corresponding Author Assi Levi docalevi@gmail.com Photodermatosis Service and Laser Unit, Division of Dermatology, Rabin Medical Center, Petah-Tikva, Israel Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel Correspondence Assi Levi, Division of Dermatology, Rabin Medical Center, 39 Jabotinsky St., Petah Tikva 4941492, Israel. Email: docalevi@gmail.comSearch for more papers by this author Yossi Taieb, Yossi Taieb Photodermatosis Service and Laser Unit, Division of Dermatology, Rabin Medical Center, Petah-Tikva, Israel Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, IsraelSearch for more papers by this authorEmmilia Hodak, Emmilia Hodak Photodermatosis Service and Laser Unit, Division of Dermatology, Rabin Medical Center, Petah-Tikva, Israel Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, IsraelSearch for more papers by this authorElena Didkovsky, Elena Didkovsky Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel Department of Pathology, Rabin Medical Center, Petah-Tikva, IsraelSearch for more papers by this authorClaes David Enk, Claes David Enk Department of Dermatology, Hadassah-Hebrew University Medical Center, Jerusalem, IsraelSearch for more papers by this authorNadav Astman, Nadav Astman Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel Department of Dermatology, Sheba Medical Center, Tel-Hashomer, Israel Israel Defense Forces Medical Corps, Tel Hashomer, Ramat Gan, IsraelSearch for more papers by this authorAssi Levi, Corresponding Author Assi Levi docalevi@gmail.com Photodermatosis Service and Laser Unit, Division of Dermatology, Rabin Medical Center, Petah-Tikva, Israel Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel Correspondence Assi Levi, Division of Dermatology, Rabin Medical Center, 39 Jabotinsky St., Petah Tikva 4941492, Israel. Email: docalevi@gmail.comSearch for more papers by this author First published: 28 November 2020 https://doi.org/10.1111/phpp.12631Citations: 1Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat No abstract is available for this article. Open Research DATA AVAILABILITY STATEMENT The data that support the findings of this study are available on request from the corresponding author. The data are not publicly available due to privacy or ethical restrictions. Citing Literature Volume37, Issue3May 2021Pages 195-197 RelatedInformation

BACKGROUND:Atopic dermatitis is a chronic inflammatory skin disease. Methotrexate is an off-label systemic agent for treating uncontrolled atopic dermatitis. OBJECTIVE:This study assessed the safety and efficacy of methotrexate in pediatric patients with atopic dermatitis. METHODS:This multicenter, retrospective study assessed pediatric patients with atopic dermatitis who were treated with methotrexate. RESULTS:Medical records of 26 pediatric patients with atopic dermatitis were reviewed. All the patients had Investigator Global Assessment (IGA) scores of 3-4 and had received systemic therapy before receiving methotrexate. In all, 53.85% patients showed clinical improvement at 3 and 6 months after methotrexate initiation. The IGA scores of the patients decreased significantly at 3 months after methotrexate initiation compared with those at baseline; moreover, the IGA scores of the patients at 6 months after methotrexate initiation were lower than those at 3 months after methotrexate initiation. In all, 54% study patients are still undergoing methotrexate treatment. Median satisfaction rate with methotrexate was 7.5/10. However, 10.35% patients developed adverse events, of which only one patient discontinued the treatment. CONCLUSIONS:Our results indicate that methotrexate is a tolerable and effective agent for treating refractory childhood atopic dermatitis.