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Page 8 of 10 Abadías-Granado et al. Plast Aesthet Res 2021;8:27 https://dx.doi.org/10.20517/2347-9264.2020.199

Regarding non-melanoma skin cancer, a recent study investigated the microbiomes of actinic keratosis
(AK) and cutaneous squamous cell carcinoma (SCC) in immunocompetent men either longitudinally or
[52]
cross-sectionally . Propionibacterium and Malassezia were relatively most frequently found in healthy
perilesional areas, whereas Staphylococcus was more abundant in both AK and SCC, with a predominance
of the S. aureus species. Particularly, eleven Operational Taxonomic Units (OTUs) of S. aureus were
identified in the participating subjects; six of these were significantly associated with SCCs, with OTUs 50
and 216 present in all patients, suggesting their specific involvement in progression from AK to SCC .
[52]
Lately, these results have been confirmed, finding an overabundance of S. aureus in SCC and AK compared
with basal cell carcinoma samples. Consequently, as Malassezia was decreased in SCCs, it is hypothesized
[53]
that this yeast could be protective against S. aureus over-colonization [Table 1].

According to this local possible pathogenic effect of the skin microbiota in the promotion and/or
progression of skin cancer, a recent study established the role of the gut microbiota in the response to anti-
PD-1 immunotherapy in patients with metastatic melanoma. A significant association between the presence
of some specific bacteria such as Bifidobacterium longum, Collinsella aerofaciens, and Enterococcus faecium
[54]
and a positive clinical response to the therapy was found . According to this, reconstitution of germ-free
mice with fecal material from responders improved tumor control, enhanced T cell responses, and
increased efficacy of anti-PD-L1 therapy. These results suggest that commensal microbiome may modulate
anti-tumor immunity in cancer patients .
[54]
CONCLUSION
Multiple studies indicate that age plays a critical role in modifying the human microbiota.

Furthermore, it appears that the microbiota may interact with ultraviolet radiation, facilitating skin damage
and skin cancer or protecting against them. This knowledge opens the possibility of modulating the
microbiota to maintain or improve health during aging. Thus, topical and oral probiotics are a promising
therapy in the prevention of premature skin aging.

DECLARATIONS
Authors’ contributions
Conceptualization, investigation, writing original draft: Abadías-Granado I
Investigation, writing original draft: Sánchez-Bernal J
Conceptualization, supervision, writing, review and editing: Gilaberte Y

Availability of data and materials
Not applicable.

Financial support and sponsorship
None.

Conflicts of interest
All authors declared that there are no conflicts of interest.

Ethical approval and consent to participate
Not applicable.