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
Processing time: 90 Days and 16.5 Hours
This retrospective cohort study was completed to evaluate the impact of fecal microbiota transplant (FMT) on skin disease, a subject not currently well-studied.
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.
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.
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.
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.
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.
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.