Detailed microbiome analysis of sticker-stripped surface materials of acne lesions revealed acne-related Cutibacterium acnes subtypes: a pilot study

Cutibacterium acnes (C. acnes) is known to play a central role in pathogenesis of acne vulgaris. It has been understood that multiple phylotypes of C. acnes exist, with certain types being more prevalent in patient with acne vulgaris and others more common in healthy individuals. In this context, we conducted a preliminary study using self-collected samples via an adhesive sticker (MySkin® patch) to analyze the skin microbiome of Japanese women. The study aimed to determine the role of C. acnes and its specific phylotypes in the development of acne vulgaris. Participants in this study were Japanese females aged between their 20s and 40s. Dermatologists evaluate the data from web-based questionnaires and smartphone image submissions to classify subjects into either Acne group (n = 219) or Non-acne group (n = 77). Quality assessment of DNA extracted from the sticker was conducted, followed by amplification of the 16S rRNA region using PCR. Subsequent microbial community analysis was performed using next-generation sequencing techniques. Genetic classification of C. acnes was accomplished through single locus sequence typing. Results indicated a bacterial community composition on the facial skin surface predominantly consisting of C. acnes clusters, with over half of these clusters constituted by C. acnes . Notably, the Acne group exhibited a significantly higher proportion of C. acnes relative to total bacterial presence compared to the Non-acne group. Analysis of C. acnes phylotypes revealed a markedly lower presence of type III (subspecies elongatum ) in the Acne group (vs. Non-acne group, p < 0.05). No significant differences were observed in the prevalence of Types IA1, IA2, II, and IB between the two groups. The predominantsequence types (ST) of C. acnes identified were IA2\_2\_F0 (23.9%), IA1\_4\_A0 (20.6%), and II\_2\_K0 (18.6%). Within the Acne group, an increase in IA2\_1\_F1 and a decrease in III\_1\_L0 were observed (vs. Non-acne group, p < 0.05). This study underscores the feasibility of using self-collected and mailed-in samples for qPCR and microbiome analysis, maintaining diagnostic quality comparable to in-person assessments. Furthermore, the variation in the expression of C. acnes phylotypes across skin surfaces between acne-afflicted and healthy individuals could suggest that shifts in phylotype expression patterns may be indicative of skin susceptibilities to acne development. ### Competing Interest Statement The authors have declared no competing interest.