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Article History

Received: 16 November 2024

Revised: 31 January 2025

Accepted: 3 February 2025

First Online: 26 February 2025

Declarations

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: This case-control study was approved by the local ethical board of the Habib Bourguiba University Hospital of Sfax (protocol number of ethical committee, 4/12). The patients in this manuscript have given written informed consent to the publication of their case details.

: Accumulated knowledge suggests that several autoimmune processes are triggered by a disturbed microbiome, which in turn causes a dysregulated immune system that favors pro-inflammatory pathways. It has been gradually discovered that there may be a connection between gut microbiota and autoimmune bullous disorders. Pemphigus vulgaris and pemphigoid showed promising results. Nevertheless, the role of antimicrobial peptides (AMPs) and the skin microbiota in pemphigus foliaceus remains unclear. Our study comprehensively explains the AMP and skin microbiota in Tunisian endemic PF patients. A markedly different AMP distribution pattern was observed among PF-stratified patients. In addition, compared to non-lesioned skin, lesioned skin exhibited a reduced microbiome diversity and a lower abundance of specific bacterial genera, namely Dermabacter, Psychrobacter, and Bradyrhizobium. Thus, bacterial communities of PF active skin lesions show reduced richness and a notable over-representation of Staphyloccocaceae.

: The authors declare no competing interests.