The article reviews the role of the skin microbiome in inflammatory skin diseases (ISDs) such as psoriasis, rosacea, atopic dermatitis (AD), seborrheic dermatitis (SD), diaper dermatitis (DD), and *Malassezia folliculitis*. The skin, the body's largest organ, is colonized by a diverse microbial community that plays a crucial role in resisting pathogens, supporting the immune system, and metabolizing natural products. Dysregulation of the skin microbiota can lead to immune dysregulation and inflammatory responses, contributing to the onset and exacerbation of ISDs. The skin microbiota undergoes changes in composition and function, which can compromise the skin's microbial barrier, leading to water loss, abnormal lipid metabolism, and the release of toxins that impair skin barrier function and allow microorganisms to enter the bloodstream, activating immune disorders and subsequent inflammatory responses. The article highlights the specific microbial alterations and immune dysregulation features in each ISD. For example, in AD, there is a decrease in skin microbial diversity, with a higher abundance of *Staphylococcus aureus*, which can produce toxins that dissolve the stratum corneum and impair skin barrier function. In psoriasis, *S. aureus* and *Streptococcus pyogenes* are associated with disease exacerbations, stimulating the innate immune system and leading to Th17 cell differentiation and the production of pro-inflammatory mediators. In SD, *Malassezia* plays a significant role by releasing enzymes that decompose sebum and trigger inflammatory responses, while *Candida albicans* shares similarities with pathogens in its ability to colonize and invade through biofilm formation. The article also discusses the potential therapeutic approaches based on understanding the skin microbiome's role in ISDs, including the development of targeted therapies that address microbial dysbiosis. The review emphasizes the importance of multi-omics sequencing and meta-gene analysis in studying the interactions between the skin microbiome and the immune system, providing insights into the pathogenesis of ISDs and potential clinical applications.The article reviews the role of the skin microbiome in inflammatory skin diseases (ISDs) such as psoriasis, rosacea, atopic dermatitis (AD), seborrheic dermatitis (SD), diaper dermatitis (DD), and *Malassezia folliculitis*. The skin, the body's largest organ, is colonized by a diverse microbial community that plays a crucial role in resisting pathogens, supporting the immune system, and metabolizing natural products. Dysregulation of the skin microbiota can lead to immune dysregulation and inflammatory responses, contributing to the onset and exacerbation of ISDs. The skin microbiota undergoes changes in composition and function, which can compromise the skin's microbial barrier, leading to water loss, abnormal lipid metabolism, and the release of toxins that impair skin barrier function and allow microorganisms to enter the bloodstream, activating immune disorders and subsequent inflammatory responses. The article highlights the specific microbial alterations and immune dysregulation features in each ISD. For example, in AD, there is a decrease in skin microbial diversity, with a higher abundance of *Staphylococcus aureus*, which can produce toxins that dissolve the stratum corneum and impair skin barrier function. In psoriasis, *S. aureus* and *Streptococcus pyogenes* are associated with disease exacerbations, stimulating the innate immune system and leading to Th17 cell differentiation and the production of pro-inflammatory mediators. In SD, *Malassezia* plays a significant role by releasing enzymes that decompose sebum and trigger inflammatory responses, while *Candida albicans* shares similarities with pathogens in its ability to colonize and invade through biofilm formation. The article also discusses the potential therapeutic approaches based on understanding the skin microbiome's role in ISDs, including the development of targeted therapies that address microbial dysbiosis. The review emphasizes the importance of multi-omics sequencing and meta-gene analysis in studying the interactions between the skin microbiome and the immune system, providing insights into the pathogenesis of ISDs and potential clinical applications.