Human Skin Is the Largest Epithelial Surface for Interaction with Microbes.
J Invest Dermatol. 2017 Apr 8. pii: S0022-202X(17)31164-8. doi: 10.1016/j.jid.2016.11.045.
The biggest quantity of germs is in the gut, more exactly in the colon. Effects of the flora are numerous (please see the figure “Microbiome influences on the human body) https://telemedskin.com/childhood-eczema-and-germs-in-the-gut/
However the skin provides a large surface of contact with bacteria and other organisms. “A careful study of the skin using laser- capture microdissection and in situ hybridization has revealed that microbes reside not only on the external interfollicular epithelial surface but also on the entire skin appendage surface and even below the basement membrane.
It is widely accepted that the total surface area of the skin is of 2 square meters. However this might be a gross underestimation as the presence of appendages* multiplies the total surface more than 10-fold to 25 square meters.
-The authors demonstrate this in this article published in JID, by recalculating the surface taking into account appendages.
Appendages are to the skin what villi and microvilli are to the gut and the potential for interactions in these areas cannot be ignored. “Healthy bacteria have already been shown to play a role in Atopic Dermatitis: https://telemedskin.com/why-healthy-bacteria-are-so-important-in-normal-skin/)
*Appendages include hair follicles, eccrine ducts, apocrine ducts, and sebaceous glands
Article selected by Saurat JH, MD