Retrospective Cohort Study
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Dermatol. Jan 25, 2021; 9(1): 1-10
Published online Jan 25, 2021. doi: 10.5314/wjd.v9.i1.1
Fecal microbiota transplant and dermatologic disorders: A retrospective cohort study assessing the gut microbiome’s role in skin disease
Ashley M Snyder, James Abbott, M Kyle Jensen, Aaron M Secrest
Ashley M Snyder, James Abbott, Aaron M Secrest, Department of Dermatology, University of Utah, Salt Lake City, UT 84132, United States
Ashley M Snyder, Aaron M Secrest, Department of Population Health Sciences, University of Utah, Salt Lake City, UT 84108, United States
M Kyle Jensen, Division of Pediatric Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, University of Utah, Salt Lake City, UT 84113, United States
Author contributions: Snyder AM and Secrest AM coordinated IRB approval and data access; Snyder AM and Abbott J were the primary authors involved in data analysis and collection and so had access to the data and data source throughout the study, though all authors were allowed access if needed during the process; Jensen MK provided further assistance in data evaluation and collection. All authors provided input in methods development for this project; Snyder AM was the primary author of the manuscript, and all authors were involved in revising and approving of the manuscript.
Institutional review board statement: Exempt status was obtained from the University of Utah Institutional Review Board (#76927).
Conflict-of-interest statement: The authors have no conflicts-of-interest to declare.
Data sharing statement: Due to the limited patient population, we are not sharing data as the patients cannot be adequately de-identified.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Corresponding author: Ashley M Snyder, MPH, Graduate Assistant, Department of Dermatology, University of Utah, 30 North 1900 East, 4A330, Salt Lake City, UT 84132, United States.
Received: October 19, 2020
Peer-review started: October 19, 2020
First decision: December 1, 2020
Revised: December 10, 2020
Accepted: December 23, 2020
Article in press: December 23, 2020
Published online: January 25, 2021

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.


To identify associations between FMT and skin conditions, particularly infectious and inflammatory etiologies, and the role of dermatology post-FMT.


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.


Most patients were female (61.5%) and ethnically not Hispanic or Latino (93.6%). 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.


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.

Keywords: Fecal microbiota transplantation, Infections, Inflammation, Microbiota, Skin diseases, Retrospective studies

Core Tip: Recent evidence indicates fecal microbiota transplant could affect certain skin diseases and their treatment. Given that our study indicated no clear pattern of infectious or inflammatory skin disease after fecal microbiota transplant but also that dermatology follow-up was not common, future studies should either use retrospective data sources with more complete dermatology records for patients receiving fecal microbiota transplant or attempt large prospective studies.