Alghuyaythat Waleed Khalid Z, Alfaifi Fawziah Salman, Alshalhoob Hind Bader S, Abanumay Rana Khalid A, Asiree Rayan Hussain A, Alnumayr Haya Sulaiman, Alanazi Anwar Ghudair T, Alluli Maryam Mohammed
College of Medicine, Majmaah University, Majmaah, Saudi Arabia.
Department of Dermatology, King Faisal Medical City for Southern Region (KFMC), Abha, Saudi Arabia.
Front Physiol. 2025 May 9;16:1556998. doi: 10.3389/fphys.2025.1556998. eCollection 2025.
The available evidence on probiotics in Dermatitis Herpetiformis (DH) remains severely limited. Given the shared pathophysiology of DH and Coeliac disease (CD), we aimed to provide the hypothesis to synthesize the narrative reviews carried out so far on the use of probiotics in the treatment of DH, its impact on gut microbiota dysbiosis, and the gut-skin axis.
Relevant narrative reviews were searched for in electronic databases such as PubMed, Scopus, Cochrane Library, Embase, and Google Scholar.
All 7 included reviews commented on gut microbiota dysbiosis as a common feature in patients with CD and DH. Immune modulation, attenuation of intestinal permeability, and anti-inflammatory effects were some of the postulated effects of probiotics. Probiotics could modulate the gut-skin axis and may prove therapeutic for DH; however, most of the evidence was indirect, drawn from models of CD or theoretically derived.
While probiotics showed promise for managing gut dysbiosis and immune regulation in DH, the existing evidence remains speculative. Our results suggest that probiotics could be a useful adjunct to gluten-free dieting in DH treatment, but future studies are needed to support this finding.
关于益生菌在疱疹样皮炎（DH）中的现有证据仍然极为有限。鉴于DH与乳糜泻（CD）的共同病理生理学，我们旨在提出一种假设，以综合目前已开展的关于使用益生菌治疗DH、其对肠道微生物群失调的影响以及肠-皮肤轴的叙述性综述。
在PubMed、Scopus、Cochrane图书馆、Embase和谷歌学术等电子数据库中检索相关的叙述性综述。
纳入的所有7篇综述均指出，肠道微生物群失调是CD和DH患者的一个共同特征。免疫调节、肠道通透性减弱和抗炎作用是益生菌的一些假定作用。益生菌可以调节肠-皮肤轴，可能对DH有治疗作用；然而，大多数证据是间接的，来自CD模型或理论推导。
虽然益生菌在管理DH的肠道失调和免疫调节方面显示出前景，但现有证据仍然是推测性的。我们的结果表明，益生菌可能是DH治疗中无麸质饮食的有用辅助手段，但需要未来的研究来支持这一发现。
