皮肤菌群：修订间差异
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[[File:Skin_Microbiome20169-300.jpg|thumb|描绘[[人体]]和占主导地位的[[细菌]]]]
'''皮肤菌群'''（英语：Skin flora）也称为'''皮肤微生物群'''（英语：Skin microbiota），
其中占大多数的是[[细菌]]，人体皮肤上约有1000种细菌，分别来自19个[[门 (生物)|门]]。<ref name="Grice">{{cite journal |vauthors=Grice EA, Kong HH, Conlan S |year=2009 |title=Topographical and Temporal Diversity of the Human Skin Microbiome |journal=[[Science (journal)|Science]] |volume=324 |issue=5931 |pages=1190–92 |bibcode=2009Sci...324.1190G |doi=10.1126/science.1171700 |pmc=2805064 |pmid=19478181}}</ref><ref name="Pappas">{{Cite web|title=Your Body Is a Wonderland ... of Bacteria|url=https://www.science.org/content/article/your-body-wonderland-bacteria|access-date=2023-01-02|website=www.science.org|language=en|archive-date=2022-12-09|archive-url=https://web.archive.org/web/20221209025548/https://www.science.org/content/article/your-body-wonderland-bacteria|dead-url=no}}</ref>大多数存在于[[表皮]]的表层和[[毛囊]]的上部。
皮肤菌群通常是非[[病原体|致病性]]的，并且是[[偏利共生]]（对宿主无害）或[[互利共生|互惠共生]]的（双方获益）。细菌可以提供的好处包括通过竞争[[营养]]、分泌[[化学物质]]或刺激皮肤的[[免疫系统]]以防止短暂的致病生物在皮肤表面[[定殖]]。<ref name="Cogen">{{cite journal |vauthors=Cogen AL, Nizet V, Gallo RL |year=2008 |title=Skin microbiota: a source of disease or defence? |journal=Br J Dermatol |volume=158 |issue=3 |pages=442–55 |doi=10.1111/j.1365-2133.2008.08437.x |pmc=2746716 |pmid=18275522}}</ref>然而，常驻微生物也可能引起[[皮膚病|皮肤病]]并进入[[循环系统|血液系统]]，造成危及生命的疾病，尤其是在[[免疫抑制]]人群中。<ref name="Cogen" />
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一项对100名年轻人脚趾间区域的研究发现了14种不同的[[真菌]]。这些包括[[酵母|酵母菌]]，例如[[白色念珠菌]]、[[深红酵母]]和[[皮状丝孢酵母]]；[[皮癬菌|皮癣菌]]真菌，例如[[石膏样小孢子菌]]和[[红色毛癣菌]]；[[非皮癣菌]]真菌，例如[[黑根霉]]、[[皮状丝孢酵母]]、[[鐮孢菌屬|镰孢菌]]、[[短柄帚霉]]、[[弯孢属|弯孢]]、[[链格孢菌]]、[[拟青霉属|拟青霉]]、[[黃麴霉|黄曲霉]]和[[青黴菌|青霉菌]]物种。<ref>{{cite journal |vauthors=Oyeka CA, Ugwu LO |year=2002 |title=Fungal flora of human toe webs |journal=Mycoses |volume=45 |issue=11–12 |pages=488–91 |doi=10.1046/j.1439-0507.2002.00796.x |pmid=12472726 |s2cid=8789635}}</ref>
[[美国]][[马里兰州]][[贝塞斯达 (马里兰州)|贝塞斯达]]的[[国家人类基因组研究所]]进行了一项研究，调查了人体14个不同位置的皮肤真菌的DNA。这些位置分别是[[耳道]]、[[眉毛]]之间、[[后脑|后脑勺]]、耳后、[[踵|脚跟]]、脚趾甲、脚趾之间、[[前臂]]、[[背|背部]]、[[鼠蹊|腹股沟]]、[[鼻|鼻孔]]、[[胸|胸部]]、[[手|手掌]]和肘窝。研究表明，人体各个部位的真菌种类繁多，其中最丰富的栖息地是脚跟，那里有大约80种真菌。相比之下，脚趾甲上有大约60种物种，而脚趾之间有40种物种。其他富含真菌的区域包括手掌、前臂和肘窝内，其真菌物种数在18到32种之间。头部和躯干各有2到10种。<ref>{{Cite news|date=2013-05-22|title=Feet home to more than 100 fungi|language=en-GB|work=BBC News|url=https://www.bbc.com/news/health-22622689|access-date=2023-01-02|archive-date=2023-01-02|archive-url=https://web.archive.org/web/20230102040430/https://www.bbc.com/news/health-22622689|dead-url=no}}</ref>
==== 脐带的微生物组 ====
[[肚脐]]是身体的一个部位。肚脐很少暴露于[[紫外线]]、[[肥皂]]或身体分泌物（肚脐不产生任何分泌物或[[三酸甘油酯|油脂]]）<ref name="esa2011">{{Cite web|last=Ecological Society of America|date=2011-08-04|title=Bellybutton microbiomes: Ecological research on the human biome|url=https://www.sciencedaily.com/releases/2011/08/110803174757.htm|access-date=2013-04-20|work=ScienceDaily|format=Press Release|archive-date=2023-07-22|archive-url=https://web.archive.org/web/20230722125301/https://www.sciencedaily.com/releases/2011/08/110803174757.htm|dead-url=no}}</ref><ref>{{cite news|last=Nierenberg|first=Cari|title=New meaning to 'navel-gazing': Scientists study belly button bacteria|url=https://www.nbcnews.com/health/new-meaning-navel-gazing-scientists-study-belly-button-bacteria-1C6437445?franchiseSlug=healthmain|access-date=2013-09-29|date=2011-04-14|archive-date=2023-03-18|archive-url=https://web.archive.org/web/20230318120238/https://www.nbcnews.com/health/new-meaning-navel-gazing-scientists-study-belly-button-bacteria-1C6437445?franchiseSlug=healthmain|dead-url=no}}</ref>，由于它是一个几乎不受干扰的细菌群落<ref name="Hulcr">{{cite journal |last=Hulcr |first=Jirir |author2=Andrew M. Latimer |author3=Jessica B. Henley |author4=Nina R. Rountree |author5=Noah Fierer |author6=Andrea Lucky |author7=Margaret D. Lowman |author8=Robert R. Dunn |date=7 November 2012 |title=A Jungle in There: Bacteria in Belly Buttons are Highly Diverse, but Predictable |journal=PLOS ONE |volume=7 |issue=11 |pages=e47712 |bibcode=2012PLoSO...747712H |doi=10.1371/journal.pone.0047712 |pmc=3492386 |pmid=23144827 |doi-access=free}}</ref>，所以它是研究皮肤微生物组的一个很好的部位。<ref>{{cite web|title=The Wild Life of Your Body|url=http://www.yourwildlife.org/projects/belly-button-biodiversity/|access-date=1 September 2013|archive-date=2014-08-10|archive-url=https://web.archive.org/web/20140810200343/http://www.yourwildlife.org/projects/belly-button-biodiversity/|dead-url=no}}</ref>肚脐是人体的潮湿微生物组（湿度和温度都很高）<ref name="Kong">{{cite journal |last=Kong |first=Hiedi |date=June 17, 2011 |title=Skin microbiome: genomics-based insights into the diversity and role of skin microbes |journal=Trends Mol. Med. |volume=17 |issue=6 |pages=320–8 |doi=10.1016/j.molmed.2011.01.013 |pmc=3115422 |pmid=21376666}}</ref><ref name="ncbi.nlm.nih.gov">{{cite journal |last=Grice |first=Elizabeth |author2=Julia Segre |date=9 April 2011 |title=The Skin Microbiome |journal=Nat Rev Microbiol |volume=9 |issue=4 |pages=244–53 |doi=10.1038/nrmicro2537 |pmc=3535073 |pmid=21407241}}</ref>，含有大量细菌<ref>{{cite news|last=Kaplan|first=Karen|title=Study shows you're covered in bacteria - live with it.|url=http://www.highbeam.com/doc/1G1-200941418.html?key=01-42160D517E1A14691A0E031B07664B36254D35463B78700E730E0B60641A617F1371193F|archive-url=https://web.archive.org/web/20131111044351/http://www.highbeam.com/doc/1G1-200941418.html?key=01-42160D517E1A14691A0E031B07664B36254D35463B78700E730E0B60641A617F1371193F|url-status=dead|archive-date=11 November 2013|access-date=29 September 2013|newspaper=The Star|date=1 June 2009}}</ref>，尤其是棒状杆菌<ref>{{cite journal |last=Grice |first=Elizabeth |author2=Heidi H. Kong |author3=Sean Conlan |author4=Clayton B. Deming |author5=Joie Davis |author6=Alice C. Young |author7=Gerard G. Bouffard |author8=Robert W. Blakesley |author9=Patrick R. Murray |author10=Eric D. Green |author11=Maria L. Turner |date=29 May 2009 |title=Topographical and Temporal Diversity of the Human Skin Microbiome |url=https://archive.org/details/sim_science_2009-05-29_324_5931/page/1190 |journal=Science |volume=324 |issue=5931 |pages=1190–2 |bibcode=2009Sci...324.1190G |doi=10.1126/science.1171700 |pmc=2805064 |pmid=19478181 |author12=Julia A. Segre}}</ref>和葡萄球菌<ref name="ncbi.nlm.nih.gov" />等喜欢潮湿环境的细菌。
肚脐生物多样性项目于2011年初在[[北卡罗来纳州立大学]]启动，最初有两组志愿者，分别由35名志愿者和25名志愿者组成。<ref name="Hulcr" />志愿者被分配了无菌[[棉花棒|棉签]]，并被要求将棉签插入他们的肚脐中，将棉签旋转三圈，然后将棉签放在装有0.5毫升10%[[磷酸鹽|磷酸盐]][[缓冲溶液|缓冲液]]的小瓶中返回给研究人员。<ref name="Parker-Pope">{{cite web|last=Parker-Pope|first=Tara|date=2011-04-14|title=What's in Your Belly Button|url=http://well.blogs.nytimes.com/2011/04/14/whats-in-your-belly-button/?_r=1|access-date=2013-09-29|archive-date=2021-03-08|archive-url=https://web.archive.org/web/20210308101237/https://well.blogs.nytimes.com/2011/04/14/whats-in-your-belly-button/?_r=1|dead-url=no}}</ref><ref name="Hulcr" />由Jiri Hulcr领导的北卡罗来纳州立大学的研究人员<ref name="Nierenberg">{{cite web|last=Nierenberg|first=Cari|title=New meaning to 'navel-gazing': Scientists study Belly Button Bacteria|url=https://www.nbcnews.com/health/new-meaning-navel-gazing-scientists-study-belly-button-bacteria-1C6437445?franchiseSlug=healthmain|access-date=2013-09-29|website=[[NBC News]]|archive-date=2023-03-18|archive-url=https://web.archive.org/web/20230318120238/https://www.nbcnews.com/health/new-meaning-navel-gazing-scientists-study-belly-button-bacteria-1C6437445?franchiseSlug=healthmain|dead-url=no}}</ref>随后在培养物中培养样本，直到细菌[[菌落]]大到可以拍照，然后将这些照片发布在肚脐生物多样性项目的网站上（志愿者获得样本编号，以便他们可以在线查看自己的样本）。<ref name="Parker-Pope" />然后使用16S核糖体RNA文库对这些样本进行分析，以便识别在培养物中生长不良的菌株。<ref name="Hulcr" />
北卡罗来纳州立大学的研究人员发现，虽然很难预测肚脐微生物组中的每一种细菌菌株，但他们可以预测哪些菌株会普遍存在，而哪些菌株会非常罕见。<ref name="Hulcr" />结果发现，肚脐微生物组仅包含几种常见的细菌，即[[葡萄球菌属|葡萄球菌]]、[[棒状杆菌属|棒状杆菌]]、[[放线菌属|放线菌]]、[[真细菌目|真细菌]]和[[芽孢桿菌綱|芽孢杆菌]]，以及许多不同类型的稀有细菌。<ref name="Hulcr" />在志愿者的肚脐内还发现了其他类型的稀有生物，包括三种[[古菌|古细菌]]，其中两种是在一名自称多年未洗澡的志愿者身上发现的。<ref name="Hulcr" />
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在这个项目的志愿者的肚脐中，葡萄球菌和棒状杆菌是最常见的细菌类型，这些类型的细菌在更大规模的皮肤微生物组研究中<ref name="Callewaert">{{cite journal |last=Callewaert |first=Chris |author2=Frederiek-Maarten Kerckhof |author3=Michael S. Granitsiotis |author4=Mireille Van Gele |author5=Tom Van de Wiele |author6=Nico Boon |date=12 August 2013 |title=Characterization of Staphylococcus and Corynebacterium Clusters in the Human Axillary Region |journal=PLOS ONE |volume=8 |issue=8 |pages=e70538 |bibcode=2013PLoSO...870538C |doi=10.1371/journal.pone.0070538 |pmc=3741381 |pmid=23950955 |doi-access=free}}</ref>（肚脐生物多样性项目是其中一部分）也被发现是皮肤微生物组中最常见的细菌类型。<ref name="Hulcr" />在这些更大规模的研究中发现，女性的皮肤微生物组中通常有更多的葡萄球菌<ref name="Callewaert" />（通常是表皮葡萄球菌）<ref name="Parker-Pope" />，而男性的皮肤微生物组中则有更多的棒状杆菌。<ref name="Callewaert" />
根据北卡罗来纳州立大学的肚脐生物多样性项目<ref name="Hulcr" />，在肚脐和周围区域发现了两种类型的微生物。短暂性细菌（不繁殖的细菌）<ref name="Kong" />构成了肚脐中发现的大部分生物，估计在95%的研究参与者中发现了1400多种不同的菌株。<ref name="saunders-blog">{{Cite web|last=Saunders|first=Chris|date=2011-07-12|title=Navel gazing at NC State leads to important discovery|url=http://www.alumniblog.ncsu.edu/2011/07/12/navel-gazing-at-nc-state-leads-to-important-discovery/|access-date=2013-04-20|work=Red & White for Life :: NC State University Alumni Association|archive-date=2016-12-14|archive-url=https://web.archive.org/web/20161214183347/https://www.alumniblog.ncsu.edu/2011/07/12/navel-gazing-at-nc-state-leads-to-important-discovery/|dead-url=no}}</ref>
肚脐生物多样性项目正在进行中，现在已经从500多人身上取了样本。<ref name="Hulcr" />该项目的设计旨在反驳一个错误观念，即即细菌总是对人类有害的<ref>{{cite web|last=Aldhous|first=Peter|title=Belly button biome is more than a piece of fluff|url=http://newscientist.com/blogs/shortsharpscience/2011/04/belly-button-biome-is-more-tha.html|access-date=2013-09-29|archive-date=2013-10-02|archive-url=https://web.archive.org/web/20131002214747/http://newscientist.com/blogs/shortsharpscience/2011/04/belly-button-biome-is-more-tha.html|dead-url=no}}</ref>，而人类正在与细菌作战。<ref>{{cite web|title=Human microbes|url=http://www.bbc.co.uk/programmes/b011jv8r|access-date=2013-09-29|archive-date=2023-06-13|archive-url=https://web.archive.org/web/20230613032822/https://www.bbc.co.uk/programmes/b011jv8r|dead-url=no}}</ref>实际上，即使对人体无益<ref>{{cite journal |last=Ahmad |first=Salar |author2=Shailly Anand |author3=Rup Lal |date=September 2012 |title=Skin Commensals Regulate Skin Immunity |journal=Indian J. Microbiol. |volume=52 |issue=3 |pages=517–8 |doi=10.1007/s12088-012-0301-z |pmc=3460106 |pmid=23997352}}</ref>，大多数细菌菌株也是无害的。<ref name="ncbi.nlm.nih.gov" />该项目的另一个目标是培养公众对微生物学的兴趣。<ref name="Nierenberg" />与人体微生物组计划协作，肚脐生物多样性项目还研究人类微生物组与[[年龄]]、[[性别]]、[[人種|种族]]、地点<ref name="Nierenberg" />和整体健康等因素之间的联系。<ref>{{cite journal |last=Grice |first=Elizabeth |author2=Julia Segre |date=6 June 2012 |title=The Human Microbiome: Our Second Genome |journal=Annu Rev Genom Hum Genet |volume=13 |issue=1 |pages=151–70 |doi=10.1146/annurev-genom-090711-163814 |pmc=3518434 |pmid=22703178}}</ref>
== 与宿主的关系 ==
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* 青少年和成人皮脂腺中的丙酸杆菌可以将其[[氨基酸]]转化为[[丙酸]]{{cn|date=August 2022}}
* 表皮葡萄球菌通过将汗液分解成[[3-甲基丁酸|异戊酸]]（3-甲基丁酸）来产生体味。<ref>{{cite journal |vauthors=Ara K, Hama M, Akiba S, etal |year=2006 |title=Foot odor due to microbial metabolism and its control |url=https://semanticscholar.org/paper/b9a469f89007f9c1189425e0b9d822a9547ac09c |journal=Can. J. Microbiol. |volume=52 |issue=4 |pages=357–64 |doi=10.1139/w05-130 |pmid=16699586 |s2cid=36221022}}</ref>
* [[枯草桿菌|枯草杆菌]]会产生强烈的脚臭。<ref>{{cite journal |vauthors=Ara K, Hama M, Akiba S, Koike K, Okisaka K, Hagura T, Kamiya T, Tomita F |year=2006 |title=Foot odor due to microbial metabolism and its control |url=http://pda.teron.ru/index.php?app%3Dcore%26attach_id%3D125071%26module%3Dattach%26section%3Dattach |journal=Can J Microbiol |volume=52 |issue=4 |pages=357–64 |doi=10.1139/w05-130 |pmid=16699586 }}{{Dead link}}</ref>
== 皮肤防御 ==
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=== 酸度 ===
皮肤的表层自然呈酸性（[[pH值]]4至4.5），这是由于汗液中的[[乳酸]]和皮肤细菌分泌的乳酸所致。<ref name="Lambers">{{cite journal |vauthors=Lambers H, Piessens S, Bloem A, Pronk H, Finkel P |year=2006 |title=Natural skin surface pH is on average below 5, which is beneficial for its resident flora |url=https://archive.org/details/sim_international-journal-of-cosmetic-science_2006-10_28_5/page/359 |journal=International Journal of Cosmetic Science |volume=28 |issue=5 |pages=359–70 |doi=10.1111/j.1467-2494.2006.00344.x |pmid=18489300 |s2cid=25191984}}</ref>在这种pH值下，共生菌如[[葡萄球菌属|葡萄球菌]]、[[微球菌属|微球菌]]、[[棒状杆菌属|棒状杆菌]]和[[丙酸桿菌屬|丙酸杆菌]]可以生长，但瞬时细菌不会生长，例如[[革兰氏阴性菌]]（如[[埃希氏菌属|埃希氏菌]]和[[假单胞菌属|假单胞菌]]）或[[革蘭氏陽性菌|革兰氏阳性菌]]（如[[金黃色葡萄球菌|金黄色葡萄球菌]]）。<ref name="Lambers" />影响病原菌生长的另一个因素是皮肤分泌的抗菌物质在酸性条件下会得到增强。而在碱性条件下，细菌不再附着在皮肤上，更容易脱落。据观察，皮肤在碱性条件下也会肿胀并张开，使得细菌可以更轻易地移动到表面。<ref name="Lambers" />
=== 免疫系统 ===
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=== 寻常痤疮 ===
寻常痤疮是一种常见的皮肤病，其特征是毛囊皮脂腺产生过多的皮脂和皮肤发炎。<ref name="Fitz-Gibbon2013">{{cite journal |last1=Fitz-Gibbon |first1=S |last2=Shuta |first2=T |last3=Bor-Han |first3=C |last4=Nguyen |first4=L |last5=Du |first5=C |last6=Minghsun |first6=L |last7=Elashoff |first7=D |last8=Erfe |first8=MC |last9=Loncaric |first9=A |last10=Kim |first10=J |last11=Modlin |first11=RL |date=2013 |title=''Propionibacterium acnes'' Strain Populations in the Human Skin Microbiome Associated with Acne |url= |journal=J Invest Dermatol |volume=133 |issue=9 |pages=2152–2160 |doi=10.1038/jid.2013.21 |pmc=3745799 |pmid=23337890 |last12=Miller |first12=JF |last13=Sodergren |first13=E |last14=Craft |first14=N |last15=Weinstock |first15=GM |last16=Li |first16=H}}</ref>受影响的区域通常被[[痤瘡丙酸桿菌|痤疮丙酸杆菌]]定殖（即使在没有痤疮的人中也是共生微生物群的一员）。<ref name="Grice2014">{{cite journal |last1=Grice |first1=EA |date=2014 |title=The skin microbiome: potential for novel diagnostic and therapeutic approaches to cutaneous disease |url=http://www.edermatologynews.com/scms-journal/volume-33/june-precision-medicine/single-view/the-skin-microbiome-potential-for-novel-diagnostic-and-therapeutic-approaches-to-cutaneous-disease/9077f05398694bf23b88073641fcfa8d.html |url-status=dead |journal=Semin Cutan Med Surg |volume=33 |issue=2 |pages=98–103 |doi=10.12788/j.sder.0087 |pmc=4425451 |pmid=25085669 |archive-url=https://archive.today/20150411005758/http://www.edermatologynews.com/scms-journal/volume-33/june-precision-medicine/single-view/the-skin-microbiome-potential-for-novel-diagnostic-and-therapeutic-approaches-to-cutaneous-disease/9077f05398694bf23b88073641fcfa8d.html |archive-date=2015-04-11}}</ref>高比例的痤疮丙酸杆菌与痤疮有关，但只有某些菌株与痤疮密切相关，而其他菌株则与健康皮肤有关。痤疮丙酸杆菌的相对数量在患有痤疮和没有痤疮的人群之间是相似的。<ref name="Fitz-Gibbon2013" /><ref name="Grice2014" />
目前的治疗方法包括局部和
=== 特应性皮炎 ===
患有特应性皮炎的个体在[[病变]]和非病变皮肤中都表现出金黄色葡萄球菌数量的增加。<ref name="Grice2014" />特应性皮炎的发作与金黄色葡萄球菌定植导致的低细菌多样性有关，经过[[異位性皮膚炎#治療|标准治疗]]后，细菌多样性会增加。{{cn|date=August 2022}}
目前的治疗包括局部或全身性使用抗生素、[[皮質類固醇|皮质类固醇]]和稀释漂白浴的组合。<ref name="Kong2012">{{cite journal |last1=Kong |first1=HH |last2=Oh |first2=J |last3=Deming |first3=C |last4=Conlan |first4=S |last5=Grice |first5=EA |last6=Beatson |first6=MA |last7=Nomicos |first7=E |last8=Polley |first8=EC |last9=Komarow |first9=HD |last10=NISC Comparative Sequence Program |last11=Murray |first11=PR |date=2012 |title=Temporal shifts in the skin microbiome associated with disease flares and treatment in children with atopic dermatitis |journal=Genome Res |volume=22 |issue=5 |pages=850–9 |doi=10.1101/gr.131029.111 |pmc=3337431 |pmid=22310478 |last12=Turner |first12=ML |last13=Segre |first13=JA}}</ref>潜在的益生菌治疗包括使用皮肤共生细菌（表皮葡萄球菌）来抑制金黄色葡萄球菌的生长。在特应性皮炎发作期间，表皮葡萄球菌的种群数量已被证明会增加，以试图控制金黄色葡萄球菌种群。<ref name="Grice2014" /><ref name="Kong2012" />
婴儿[[腸道菌群|肠道微生物]]多样性低与特应性皮炎风险增加有关。<ref name="Abrahamsson2012">{{cite journal |last1=Abrahamsson |first1=TR |last2=Jakobsson |first2=HE |last3=Andersson |first3=AF |last4=Björkstén |first4=B |last5=Engstrand |first5=L |last6=Jenmalm |first6=MC |date=2012 |title=Low diversity of the gut microbiota in infants with atopic eczema |url=http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-75901 |journal=J Allergy Clin Immunol |volume=129 |issue=2 |pages=434–40, 440.e1–2 |doi=10.1016/j.jaci.2011.10.025 |pmid=22153774}}</ref>患有特应性湿疹的婴儿具有低水平的拟杆菌和高水平的杆菌。拟杆菌具有抗炎特性，这是对抗皮炎所必需的。 <ref name="Abrahamsson2012" />
=== 寻常型银屑病 ===
寻常型银屑病通常会影响较干燥的皮肤部位，例如[[肘|肘部]]和[[膝|膝盖]]。与皮脂腺部位相比，皮肤的干燥区域往往具有较高的微生物多样性和较少的种群数量。<ref name="Hannigan2013" />一项使用拭子取样技术的研究表明，富含芽孢杆菌（主要是链球菌和葡萄球菌）和放线菌（主要是棒状杆菌和丙酸杆菌）的区域与银屑病有关。<ref>{{cite journal |last1=Alekseyenko |first1=AV |last2=Perez-Perez |first2=GI |last3=De Souza |first3=A |last4=Strober |first4=B |last5=Gao |first5=Z |last6=Bihan |first6=M |last7=Li |first7=K |last8=Methé |first8=BA |last9=Blaser |first9=MJ |date=2013 |title=Community differentiation of the cutaneous microbiota in psoriasis |journal=Microbiome |volume=1 |issue=1 |page=31 |doi=10.1186/2049-2618-1-31 |pmc=4177411 |pmid=24451201}}</ref>而另一项使用活组织检查的研究将增加的杆菌和放线菌水平与健康的皮肤联系起来。而另一项使用[[活體組織檢查|活组织检查]]的研究则将芽孢杆菌和放线菌的水平增加与健康的皮肤联系起来。<ref>{{cite journal |last1=Fahlén |first1=A |last2=Engstrand |first2=L |last3=Baker |first3=BS |last4=Powles |first4=A |last5=Fry |first5=L |date=2012 |title=Comparison of bacterial microbiota in skin biopsies from normal and psoriatic skin. |url=https://www.semanticscholar.org/paper/decd0325c4347083e18b165a38a99e52eef3e6db |journal=Arch Dermatol Res |volume=304 |issue=1 |pages=15–22 |doi=10.1007/s00403-011-1189-x |pmid=22065152 |s2cid=9169314}}</ref>然而，大多数研究表明，受银屑病影响的个体在受影响区域的微生物多样性较低。
银屑病的治疗包括使用外用药物、[[光照治療|光疗]]和全身药物。<ref>{{cite journal |last1=Menter |first1=A |last2=Griffiths |first2=CE |date=2007 |title=Current and future management of psoriasis. |url=https://www.semanticscholar.org/paper/79e7cbdbfa9f020fc96faa422295a71abddc56b7 |journal=Lancet |volume=370 |issue=9583 |pages=272–84 |doi=10.1016/S0140-6736(07)61129-5 |pmid=17658398 |s2cid=7907468}}</ref>目前关于皮肤微生物群落在银屑病中的作用的研究不一致，因此没有潜在的益生菌治疗方法。
=== 酒糟鼻 ===
[[酒糟鼻]]通常与皮肤的皮脂腺部位有关。皮[[螨]][[毛囊蠕形蟎|毛囊蠕形螨]]会产生[[脂酶|脂肪酶]]，使它们能够将皮脂用作食物来源，因此它们对皮脂腺部位具有很高的亲和力。尽管它是共生皮肤微生物群的一部分，但与健康个体相比，患有酒糟鼻的患者毛囊蠕形螨数量有所增加，这表明其具有致病性。<ref>{{cite journal |last1=Casas |first1=C |last2=Paul |first2=C |last3=Lahfa |first3=M |last4=Livideanu |first4=B |last5=Lejeune |first5=O |last6=Alvarez-Georges |first6=S |last7=Saint-Martory |first7=C |last8=Degouy |first8=A |last9=Mengeaud |first9=V |last10=Ginisty |first10=H |last11=Durbise |first11=E |date=2012 |title=Quantification of ''Demodex folliculorum'' by PCR in rosacea and its relationship to skin innate immune activation. |url=https://semanticscholar.org/paper/6d33f1797c70f600d2b453ec307e068b4fe9f52b |journal=Exp Dermatol |volume=21 |issue=12 |pages=906–10 |doi=10.1111/exd.12030 |pmid=23171449 |s2cid=19722615 |last12=Schmitt |first12=AM |last13=Redoulès |first13=D}}</ref>
[[奥莱龙岛海恩德里克斯氏菌]]是一种与[[蠕形蟎屬|蠕形螨]]相关微生物，通常不存在于皮肤共生微生物群中，但它可以启动炎症通路，其启动机制与酒糟鼻患者相似。<ref name="Grice2014" />表皮葡萄球菌种群也曾从酒糟鼻患者的[[膿|脓疱]]中分离出来。然而，它们可能被蠕形螨转移到有利于生长的区域，因为蠕形螨已证明可以在面部周围传播细菌。<ref>{{cite journal |last1=Jarmuda |first1=S |last2=O'Reilly |first2=N |last3=Zaba |first3=R |last4=Jakubowicz |first4=O |last5=Szkaradkiewicz |first5=A |last6=Kavanagh |first6=K |date=2012 |title=Potential role of Demodex mites and bacteria in the induction of rosacea. |journal=J Med Microbiol |volume=61 |issue=Pt 11 |pages=1504–10 |doi=10.1099/jmm.0.048090-0 |pmid=22933353 |doi-access=free}}</ref>
目前的治疗方法包括局部和口服抗生素以及[[雷射手術|激光治疗]]。<ref>{{cite journal |last1=Cohen |first1=AF |last2=Tiemstra |first2=JD |date=2002 |title=Diagnosis and treatment of rosacea |journal=J Am Board Fam Pract. |volume=15 |issue=3 |pages=214–7 |pmid=12038728}}</ref>由于目前的研究尚未显示蠕形螨对酒糟鼻影响的明确机制，因此没有潜在的益生菌治疗方法。
== 临床 ==
=== 受感染的设备 ===
皮肤微生物是受感染的医疗设备（例如[[醫用導管|医用导管]]）的潜在来源。<ref>{{cite journal |vauthors=Martín-Rabadán P, Gijón P, Alcalá L, Rodríguez-Créixems M, Alvarado N, Bouza E |year=2008 |title=Propionibacterium acnes is a common colonizer of intravascular catheters |journal=J Infect |volume=56 |issue=4 |pages=257–60 |doi=10.1016/j.jinf.2008.01.012 |pmid=18336916}}</ref>
== 卫生学 ==
人类皮肤是许多细菌和真菌物种的宿主，其中一些已知是有害的，一些已知是有益的，但绝大多数未经研究。菌和使用杀菌和杀真菌肥皂将不可避免地导致细真菌种群对所使用的化学品产生[[抗藥性|耐药性]]。
=== 传染性 ===
皮肤菌群不容易在人与人之间传播。30秒的适度摩擦和干燥的手接触会导致只有0.07%的天然手部菌群从裸体转移，而戴手套则会导致更高的转移比例。<ref>{{cite journal |vauthors=Lingaas E, Fagernes M |year=2009 |title=Development of a method to measure bacterial transfer from hands |journal=J Hosp Infect |volume=72 |issue=1 |pages=43–9 |doi=10.1016/j.jhin.2009.01.022 |pmid=19282052}}</ref>
=== 移动 ===
最有效（减少60%至80%）的抗微生物洗涤剂是使用[[乙醇]]、[[2-丙醇|异丙醇]]和[[1-丙醇|正丙醇]]。高浓度（95％）乙醇对病毒影响最大，而细菌则更容易被正丙醇影响。<ref>{{cite journal |vauthors=Kampf G, Kramer A |year=2004 |title=Epidemiologic background of hand hygiene and evaluation of the most important agents for scrubs and rubs |url=http://www.pubmedcentral.nih.gov/picrender.fcgi?artid=523567&blobtype=pdf |journal=Clin Microbiol Rev |volume=17 |issue=4 |pages=863–93 |doi=10.1128/CMR.17.4.863-893.2004 |pmc=523567 |pmid=15489352}}</ref>
不含药物的肥皂不是很有效，以下数据进行了说明。医护人员使用非药物液体肥皂洗手一次，洗手时间为30秒。而学生或技术人员进行了20次洗手。<ref>{{cite journal |vauthors=Borges LF, Silva BL, Gontijo Filho PP |year=2007 |title=Hand washing: changes in the skin flora |url=https://archive.org/details/sim_american-journal-of-infection-control_2007-08_35_6/page/n76 |journal=Am J Infect Control |volume=35 |issue=6 |pages=417–20 |doi=10.1016/j.ajic.2006.07.012 |pmid=17660014}}</ref>
{| class="wikitable" border="1"
|+两个医院组的皮肤菌群，以每[[毫升]]的菌落形成单位表示。
!群体和手部皮肤状况
!未洗过
!洗过
|-
|医护人员身体健康
|3.47
|3.15
|-
|医护人员受伤
|3.33
|3.29
|-
|学生或技术人员健康
|4.39
|3.54
|-
|学生或技术人员受伤
|4.58
|4.43
|}
[[洗手]]的一个重要用途是防止引起[[醫療照顧相關感染|医院获得性感染]]的[[抗生素抗藥性|抗生素耐药性]]皮肤菌群的传播，例如[[耐甲氧西林金黄色葡萄球菌]]。虽然这些菌群由于抗生素而产生了抗药性，但没有证据表明推荐的[[消毒藥水|消毒药水]]在洗手时会选择抗生素抗性生物。<ref name="Weber">{{cite journal |vauthors=Weber DJ, Rutala WA |year=2006 |title=Use of germicides in the home and the healthcare setting: is there a relationship between germicide use and antibiotic resistance? |url=https://semanticscholar.org/paper/7931c1bc1331fdd3f3cc8048719e2472f8ed5e8d |journal=Infect Control Hosp Epidemiol |volume=27 |issue=10 |pages=1107–19 |doi=10.1086/507964 |pmid=17006819 |s2cid=20734025}}</ref>然而，许多微生物菌株对抗菌皂中使用的某些物质（例如[[二氯苯氧氯酚|三氯生]]）具有抗药性。<ref name="Weber" />
一项调查发现，在[[牙醫|牙医]]诊所的洗手盘中，所有肥皂都有其自己的菌群，并且平均有两到五种不同的微生物属，使用频率更高的肥皂甚至具有更多种类的菌群。<ref>{{cite journal |vauthors=Hegde PP, Andrade AT, Bhat K |year=2006 |title=Microbial contamination of "in use" bar soap in dental clinics |journal=Indian J Dent Res |volume=17 |issue=2 |pages=70–3 |doi=10.4103/0970-9290.29888 |pmid=17051871}}</ref>对公共厕所中的肥皂进行的另一项调查发现了更多的菌群。<ref>{{cite journal |vauthors=Kabara JJ, Brady MB |year=1984 |title=Contamination of bar soaps under "in-use" conditions |journal=J Environ Pathol Toxicol Oncol |volume=5 |issue=4–5 |pages=1–14 |pmid=6394740}}</ref>还有一项研究发现，非常干燥的肥皂不会被感染，而所有浸泡在水池中的肥皂都被感染了。<ref>{{cite journal |vauthors=Afolabi BA, Oduyebo OO, Ogunsola FT |year=2007 |title=Bacterial flora of commonly used soaps in three hospitals in Nigeria |journal=East Afr Med J |volume=84 |issue=10 |pages=489–95 |doi=10.4314/eamj.v84i10.9567 |pmid=18232270 |doi-access=free}}</ref>然而，对被特殊感染的肥皂的研究发现，肥皂菌群不会传播到手上。<ref>{{cite journal |vauthors=Heinze JE, Yackovich F |year=1988 |title=Washing with contaminated bar soap is unlikely to transfer bacteria |url=https://archive.org/details/sim_epidemiology-and-infection_1988-08_101_1/page/135 |journal=Epidemiol Infect |volume=101 |issue=1 |pages=135–42 |doi=10.1017/s0950268800029290 |pmc=2249330 |pmid=3402545}}</ref>
=== 受损的皮肤 ===
反复清洗皮肤会破坏保护性外层并导致水分经表皮流失。这可以表现为皮肤粗糙、干燥、瘙痒、由微生物和[[过敏原]]穿透角膜层引发的皮炎和红肿。戴手套反而会导致更多问题，因为它会产生有利于微生物生长的潮湿环境，并且还含有[[乳胶]]和[[滑石|滑石粉]]等刺激物。<ref name="Larson">{{cite journal |vauthors=Larson EL, Hughes CA, Pyrek JD, Sparks SM, Cagatay EU, Bartkus JM |year=1998 |title=Changes in bacterial flora associated with skin damage on hands of health care personnel |url=https://archive.org/details/sim_american-journal-of-infection-control_1998-10_26_5/page/n80 |journal=Am J Infect Control |volume=26 |issue=5 |pages=513–21 |doi=10.1016/s0196-6553(98)70025-2 |pmid=9795681 |doi-access=free}}</ref>
洗手会损伤皮肤，因为皮肤顶层的角质层由15至20层[[角蛋白]]盘、[[角质形成细胞|角质细胞]]组成，每层角质细胞都被一层可以用[[乙醇|酒精]]和[[清洁剂]]去除的皮肤[[脂類|脂质]]薄膜包裹。<ref>{{cite journal |author=Kownatzki E |year=2003 |title=Hand hygiene and skin health |journal=J Hosp Infect |volume=55 |issue=4 |pages=239–45 |doi=10.1016/j.jhin.2003.08.018 |pmid=14629966}}</ref>
破损的皮肤表面广泛裂纹、普遍发红或偶尔出血，这种皮肤更常被[[人葡萄球菌]]定植，并且这些细菌更可能对[[甲氧西林]]具有耐药性。<ref name="Larson" />虽然这与更强的抗生素耐药性无关，但破损的皮肤也更容易被金黄色葡萄球菌、革兰氏阴性菌、[[肠球菌]]和念珠菌定植。<ref name="Larson" />
== 与其他菌群的比较 ==
皮肤菌群与[[腸道菌群|肠道菌群]]不同，肠道菌群主要是芽孢杆菌和拟杆菌。<ref>{{cite journal |vauthors=Eckburg PB, Bik EM, Bernstein CN, Purdom E, Dethlefsen L, Sargent M, Gill SR, Nelson KE, Relman DA |year=2005 |title=Diversity of the human intestinal microbial flora |url=http://www.pubmedcentral.nih.gov/picrender.fcgi?artid=1395357&blobtype=pdf |journal=Science |volume=308 |issue=5728 |pages=1635–8 |bibcode=2005Sci...308.1635E |doi=10.1126/science.1110591 |pmc=1395357 |pmid=15831718}}</ref>肠道研究中未发现人与人之间存在低水平差异。然而，肠道菌群和皮肤菌群都缺乏[[土壤菌群]]中的多样性。<ref name="Grice" />
== 参见 ==
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* [https://web.archive.org/web/20110623011743/http://cellulitistreatmentnow.com/ 蜂窝织炎皮肤感染]
* [https://web.archive.org/web/20101210013519/http://nihroadmap.nih.gov/hmp/ 人类微生物组计划]
* [http://textbookofbacteriology.net/index.html Todar的在线细菌学教科书] {{Wayback|url=http://textbookofbacteriology.net/index.html |date=20230729025648 }}
* [https://wwwnc.cdc.gov/eid/article/7/2/70-0225_article 皮肤卫生：什么时候太干净了？] {{Wayback|url=https://wwwnc.cdc.gov/eid/article/7/2/70-0225_article |date=20230731000218 }}
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