Fecal microbiota transplant for more than Clostridioides difficile: Dermatology a new frontier

Fecal microbiota transplant(FMT)has quickly become popular in research not only for recurrent Clostridioides difficile infections but for other chronic conditions as well.Recent,small dermatologic studies have reported improvements in inflammatory skin conditions in individuals treated with FMT,but larger studies are needed to clarify this possible relationship between the skin and the gut microbiome.We conducted a single-center,retrospective chart review to assess changes in acne,dermatitis herpetiformis and/or celiac disease,eczema,and psoriasis.Due to the retrospective nature of this study and the limitations of the current electronic medical record,we were unable to adequately assess cases of these diseases in relation to FMT.However,this study informs us that improvements in retrospective data are needed to formally evaluate this possible association.The better,but more cumbersome,study design would be a prospective,observational study.We encourage others to pursue further interdepartmental research on the influence of the gut microbiome on inflammatory skin diseases.

Fecal microbiota transplant and dermatologic disorders:A retrospective cohort study assessing the gut microbiome’s role in skin disease

BACKGROUND There is indication that fecal microbiota transplant(FMT)has the potential to alter the course of chronic skin disease,but few studies have investigated this phenomenon beyond case reports.Research with larger sample sizes is needed to provide a more thorough assessment of possible associations and to establish a broader foundation upon which to base hypotheses.AIM To identify associations between FMT and skin conditions,particularly infectious and inflammatory etiologies,and the role of dermatology post-FMT.METHODS We conducted a retrospective cohort study involving a chart review of all patients whom received FMT between January 2013 and December 2019 at a single academic medical center.Dermatologic follow-up was assessed for the two years after FMT or through March 2020 for more recent procedures.Dermatologic diagnoses and visits within the study time frame were recorded and assessed for trends.This study was exploratory in nature.Descriptive statistics were calculated,and the t-test,Pearson’s chi-squared test,and Fisher’s exact test were used to calculate P values.RESULTS Median age was 38(range,17-90).In total,109 patients who underwent 111 fecal microbiota transplant events were included.Twenty-six events(23.4%)involved a dermatology office visit post-procedure,and of these events,20 out of the 26(76.9%)had an infectious or inflammatory skin condition.The mean time to first visit was 10.0(±7.0)mo.The most common diagnoses were dermatophyte,wart(s),and dermatitis,though no specific diagnoses predominated in a way indicating FMT had a significant impact.More patients with a post-FMT skin disease diagnosis had a history of Crohn’s disease compared to those without(P=0.022),but results could be affected by a small sample size.CONCLUSION Our study is limited by its retrospective nature,but the findings allow a glimpse at dermatologic conditions post-FMT.Few significant associations were found,but potential associations between FMT and skin disease should be further investigated,preferably in prospective studies,to identify how FMT might be of use for treating infectious and inflammatory skin diseases.