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
Research background

This retrospective cohort study was completed to evaluate the impact of fecal microbiota transplant (FMT) on skin disease, a subject not currently well-studied.

Research motivation

FMT has grown in popularity as a possible treatment for diseases beyond recurrent Clostridioides difficile infections, and there is growing evidence that FMT could be a treatment for skin disease. Overall, the goal was to assess potential patterns of skin disease that could be notable for future research on FMT.

Research objectives

To determine the impact of FMT on the development of skin disease post-FMT and identify pitfalls in dermatologic care that could impact future studies on this relatively underexplored subject.

Research methods

A retrospective chart review was conducted on all patients whom received FMT between January 2013 to 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. Dermatology visits and inflammatory and infectious dermatologic diagnoses were recorded.

Research results

The most common diagnoses were dermatophyte, wart(s), and dermatitis. Mean time to first dermatology visit was 10.0 (± 7.0) mo. Overall, no apparent FMT-related trends in skin disease were observed. Little information on the condition of most patients’ skin pre- and post-FMT was captured in the electronic medical record. Thus, more information is needed on dermatology visits and particularly visits within the first few months post-FMT.

Research conclusions

Due to the extended interval between FMT and dermatology visits, it was difficult to assess whether reported diseases were affected by or resulted from FMT. While FMT could potentially have clinically significant effects on certain skin diseases, this study was limited by its retrospective nature and could not find clear patterns of post-FMT skin disease. It was concluded that prospective studies may be the best avenue for further assessing the relationship between FMT and skin disease.

Research perspectives

Future research will need to address temporality of dermatologic visits after FMT to provide a better indication of the effect on skin disease. Ideally, dermatologic follow-up should occur within two months post-FMT. Given limitations of the electronic medical record, prospective studies will need to be conducted to assess future relationships between FMT and skin disease.