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However, few studies have explored microbial heterogeneity between skin sites in diseased skin, such as atopic dermatitis (AD) lesions. To address this issue, we carried out deep analysis of the microbiome and transcriptome in the skin of a large cohort of AD patients and healthy volunteers, comparing two physiologically different sites: upper back and posterior thigh. Microbiome samples and biopsies were obtained from both lesional and nonlesional skin to identify changes related to the disease process. Transcriptome analysis revealed distinct disease\u2010related gene expression profiles depending on anatomical location, with keratinization dominating the transcriptomic signatures in posterior thigh, and lipid metabolism in the upper back. Moreover, we show that relative abundance of <jats:italic>Staphylococcus aureus<\/jats:italic> is associated with disease severity in the posterior thigh, but not in the upper back. Our results suggest that AD may select for similar microbes in different anatomical locations\u2014an \"AD\u2010like microbiome,\" but distinct microbial dynamics can still be observed when comparing posterior thigh to upper back. This study highlights the importance of considering the variability across skin sites when studying the development of skin inflammation.<\/jats:p>","DOI":"10.1111\/all.14606","type":"journal-article","created":{"date-parts":[[2020,10,1]],"date-time":"2020-10-01T16:08:25Z","timestamp":1601568505000},"page":"1173-1187","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":28,"title":["Microbial and transcriptional differences elucidate atopic dermatitis heterogeneity across skin sites"],"prefix":"10.1111","volume":"76","author":[{"given":"Noora","family":"Ottman","sequence":"first","affiliation":[{"name":"Institute of Environmental Medicine Karolinska Institutet Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mauricio","family":"Barrientos\u2010Somarribas","sequence":"additional","affiliation":[{"name":"Department of Cell and Molecular Biology Karolinska Institutet Stockholm 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