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El microbioma cutáneo está compuesto por una variedad extensa de microorganismos, este se ve modificado por diversos factores y es dinámico, ya que existen variaciones a lo largo de la vida. Los microorganismos y el huésped viven bajo una relación de simbiosis, en el momento que este sistema se rompe, se produce la disbiosis y esta tiene una influencia importante en la dermatitis atópica. Se reporta que existe un alta colonizacion de los pacientes enfermos por el Staphylococcus aureus y esto concuerda con la mayoría de los estudios donde se determina el microbioma de piel lesional y no lesional de pacientes con dermatitis atópica. Otros factores como las mutaciones en la proteína filagrina aumentan la susceptibilidad de colonización por S.aureus. Por otro lado, también se han encontrado agentes microbianos con capacidades inhibitorias sobre los microorganismos patógenos y se les ha atribuido un rol protector; este hallazgo motivó a algunos autores a utilizarlos como tratamientos alternativos e inclusive en uso combinado con terapia tópica como los emolientes. Adicionalmente, se reporta el restablecimiento de la microbiota con tratamientos convencionales como los humectantes, corticoesteroides, inhibidores de calcineurina y fototerapia. Múltiples estrategias se han estudiado con el fin de restablecer la biodiversidad cutánea en un intento de buscar tratamientos eficaces que actúan sobre la modificación de los procesos de disbiosis asociados con esta enfermedad.
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