High α-diversity of skin microbiome and mycobiome in Japanese patients with vitiligo

Vitiligo is an acquired pigmentary disorder characterized by depigmented patches on the skin that majorly impact patients' quality of life. Although its etiology involves genetic and environmental factors, the role of microorganisms as environmental factors in vitiligo pathology remains under-researched. Our study explored the presence of characteristic bacterial and fungal flora in vitiligo-affected skin and investigated their potential roles in vitiligo pathogenesis. We sequenced bacterial 16S rRNA and the fungal ITS1 region from skin swabs collected at frequently affected sites, namely the forehead and back, of patients with vitiligo. We analyzed bacterial and fungal flora in lesional and non-lesional areas of patients with vitiligo compared with corresponding sites in age- and sex-matched healthy subjects. Our findings revealed elevated α-diversity in both bacterial and fungal flora within vitiligo lesions compared with healthy controls. Notably, bacterial flora exhibited a distinctive composition in patients with vitiligo, and the proportional representation of Enterococcus was inversely correlated with the degree of vitiligo progression. Gammaproteobacteria, Staphylococcus spp., and Corynebacterium spp. were more abundant in vitiligo patients, with notable Staphylococcus spp. prevalence during the stable phase on the forehead. Conversely, the proportion of Malassezia sympodialis was lower and that of Malassezia globosa was higher in the progressive phase on the back of vitiligo patients. Our study identified some characteristic bacterial and fungal groups associated with vitiligo activity and prognosis, highlighting the potential roles of microorganisms in pathogenesis and offering insights into personalized disease-management approaches. •We identified characteristic bacteria and fungi in skin of patients with vitiligo through a case-control study of orthotopic sampling.•There was no dysbiosis in the vitiligo lesions, but the lesions and non-lesions of the patients exhibited a characteristic flora composition, with a higher diversity of organisms compared to healthy controls.•Gammaproteobacteria, Staphylococcus spp., and Corynebacterium spp. were more prevalent in vitiligo patients. Staphylococcus spp. showed higher proportions in the stable phase on the forehead. The proportion of M. sympodialis were lower in vitiligo patients, while M. globosa showed higher proportions in the progressive phase on the back. On the other hand, Enterococcus spp. were