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A diagram showing different regions of the body. Each region has a pie chart that shows which bacteria are most prevalent. The most common bacterium in each region: Glabella (corynebacterineae), Alar Crease (propionibacterineae), External auditory canal (propionibacterineae), Nare (other actinobacteria), manubrioum (propionibacterineae), Axillary vault (proteobacteria), antecubital fossa (proteobacteria), Volar forearm (proteobacteria), interdigital web space (proteobacteria), hypothenar palm (proteobacteria), inguinal crease (corynebacterineae), umbilicus (corynebacterineae), toe web space (corynebacterineae, , propionibacterineae, and staphylococcaceae), reticular crease (propionibacterineae), occiput (staphylococcaceae, back (propionibacterineae), buttock (proteobacteria), gluteal crease (corynebacterineae), popliteal fossa (staphylococcaceae), plantar heel (staphylococcaceae).  Second part of the image shows that different subjects have different bacterial percentages and that these percentages change over time.
The normal microbiota varies on different regions of the skin, especially in dry versus moist areas. The figure shows the major organisms commonly found in different locations of a healthy individual’s skin and external mucosa. Note that there is significant variation among individuals. (credit: modification of work by National Human Genome Research Institute)
  • What are the four most common bacteria that are part of the normal skin microbiota?

Infections of the skin

While the microbiota of the skin can play a protective role, it can also cause harm in certain cases. Often, an opportunistic pathogen residing in the skin microbiota of one individual may be transmitted to another individual more susceptible to an infection. For example, methicillin-resistant Staphylococcus aureus ( MRSA ) can often take up residence in the nares of health care workers and hospital patients; though harmless on intact, healthy skin, MRSA can cause infections if introduced into other parts of the body, as might occur during surgery or via a post-surgical incision or wound. This is one reason why clean surgical sites are so important.

Injury or damage to the skin can allow microbes to enter deeper tissues, where nutrients are more abundant and the environment is more conducive to bacterial growth. Wound infections are common after a puncture or laceration that damages the physical barrier of the skin. Microbes may infect structures in the dermis , such as hair follicles and glands , causing a localized infection, or they may reach the bloodstream, which can lead to a systemic infection.

In some cases, infectious microbes can cause a variety of rashes or lesions that differ in their physical characteristics. These rashes can be the result of inflammation reactions or direct responses to toxins produced by the microbes. [link] lists some of the medical terminology used to describe skin lesions and rashes based on their characteristics; [link] and [link] illustrate some of the various types of skin lesions. It is important to note that many different diseases can lead to skin conditions of very similar appearance; thus the terms used in the table are generally not exclusive to a particular type of infection or disease.

Some Medical Terms Associated with Skin Lesions and Rashes
Term Definition
abscess localized collection of pus
bulla (pl., bullae ) fluid-filled blister no more than 5 mm in diameter
carbuncle deep, pus-filled abscess generally formed from multiple furuncles
crust dried fluids from a lesion on the surface of the skin
cyst encapsulated sac filled with fluid, semi-solid matter, or gas, typically located just below the upper layers of skin
folliculitis a localized rash due to inflammation of hair follicles
furuncle ( boil ) pus-filled abscess due to infection of a hair follicle
macules smooth spots of discoloration on the skin
papules small raised bumps on the skin
pseudocyst lesion that resembles a cyst but with a less defined boundary
purulent pus-producing; suppurative
pustules fluid- or pus-filled bumps on the skin
pyoderma any suppurative (pus-producing) infection of the skin
suppurative producing pus; purulent
ulcer break in the skin; open sore
vesicle small, fluid-filled lesion
wheal swollen, inflamed skin that itches or burns, such as from an insect bite

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Source:  OpenStax, Microbiology. OpenStax CNX. Nov 01, 2016 Download for free at http://cnx.org/content/col12087/1.4
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