Resources
Skin Disorders and Gastrointestinal Dysbiosis
Great Smokies Diagnostic Laboratory
The gastrointestinal tract is the largest immune reactive surface inside the human body, with a total surface area comparable to the size of a small tennis court. This surface is continually exposed to an incredible vast array of food particles, potential antigens, bacteria, and yeast that can dramatically alter the defense mechanisms of the gut mucosa, producing inflammatory responses associated with atopic eczema and other skin disorders. This may explain why gastrointestinal symptoms are more common among patients with eczema than in healthy controls.1
Ionescu and his colleagues have studied fecal and duodenal flora in patients with atopic eczema and found evidence of gastrointestinal (GI) dysbiosis and subtle malabsorption in the majority.2,3 Chronic pancreatis is another GI-related dysfunction associated with this skin disorder.4 Immune sensitivity to colonization by the gastrointestinal yeast Candida albicans or the bacteria Helicobacter pylori are also closely linked with clinical manifestation of atopic dermatitis.5-7 In fact, an exciting new study suggests that probiotics--the reinoculation of the colon with "helpful" bacteria such as lactobacillus--may improve GI barrier mechanisms in patients with atopic dermatitis and thus reduce its inflammatory symptoms.8
Other skin conditions are also closely tied to GI dysbiosis. A study by researchers in the Department of Dermatology at the Royal Infirmary in Edinburgh concluded that "a combination of objective tests of small intestinal architecture and function will detect abnormalities in most dermatitis herpetiformis patients," even in some who exhibit normal intestinal biopsy results."9
References:
1 Caffarelli C, Cavagni G, Deriu FM, Zanotti P, Atherton DJ. Gastrointestinal symptoms in atopic eczema. Arch Dis Child 1998;78(3):230-234.
2 Ionescu G, Kiehl R, Ona L and Schuler R. Abnormal fecal microflora and malabsorption phenomena in atopic eczema paitents. Journal of Advancement in Medicine 1990;3:71-89.
3 Ionescu G, Kiehl R, Wichmann-Kunz F, and Leimbeck R. Immunological significance of fungal and bacterial infections in atopic eczema. Journal of Advancement of Medicine 1990;3:47-58.
4 Kaliuzhnaia LD, Gaiduchenko LV, Gorbasenko NV, Gubko L. Hepatobiliary system function in atopic dermatitiis patients. [Russian] Vestn Dermatol Venerol 1990;9:44-48.
5 Samuilova TL, Mokronosova MA, Krasnoproshin LI, Sdokhova SA, Sergeeva AS. Candida albicans sensitization in patients with atopic bronchial asthma and atopic dermatitis [Russian]. Ter Arkh 1997;69(11):41-44.
6 Savolainen J, Lammintausta K, Kalimo K, Viander M. Candida albicans and atopic dermatitis. Clin Exp Allergy 1993;23(4):332-339.
7 Wilson WH. Eczema responsive to treatment for Helicobacter pylori. [Letter]. Ann Allergy Asthma Immunol 1995;75(3):290.
8 Majamaa H, Isolauri E. Probiotics: a novel approach in the management of food allergy. J Allergy Clin Immunol 1997;99(2):179-185.
9 Gawkrodger DG, McDonald C, O'Mahony S, Ferguson A. Small intestinal function and dietary status in dermatitis herptiformis. Gut 1991;32(40:377-382.