Gu Duoduo, Pan Ruoxin, Meng Xiaoqi, Liu Tingwei, Zhong Hui, Chen Nuoran, Xu Yang
Department of Dermatology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, People's Republic of China.
State Key Laboratory of Natural Medicines, China Pharmaceutical University, Nanjing, People's Republic of China.
Int J Dermatol. 2025 Feb;64(2):256-265. doi: 10.1111/ijd.17453. Epub 2024 Aug 30.
Melasma is an acquired chronic pigmentary disorder affecting millions of individuals worldwide. However, the pathogenesis of melasma remains unclear. This article provides a comprehensive review of the pathophysiological changes occurring in the skin microenvironment of melasma lesions, which can be summarized as follows: (1) skin barrier dysfunction and abnormal synthesis, transport, and intracellular distribution of melanin in the epidermis; (2) basement membrane damage; (3) solar elastosis, vascular changes, senescent fibroblasts, mast cell infiltration, and sebocyte participation in the dermis; and (4) systemic factors such as sex hormones and oxidative stress. Furthermore, potential therapeutic strategies are introduced to provide novel perspectives for fundamental and clinical research related to melasma.
黄褐斑是一种获得性慢性色素沉着紊乱疾病，影响着全球数百万人。然而，黄褐斑的发病机制仍不清楚。本文全面综述了黄褐斑皮损皮肤微环境中发生的病理生理变化，可总结如下：（1）皮肤屏障功能障碍以及表皮中黑色素的合成、运输和细胞内分布异常；（2）基底膜损伤；（3）真皮中的日光性弹力纤维变性、血管变化、衰老的成纤维细胞、肥大细胞浸润和皮脂腺细胞参与；（4）性激素和氧化应激等全身因素。此外，还介绍了潜在的治疗策略，为黄褐斑相关的基础和临床研究提供新的视角。
