Clinical, Cosmetic and Investigational Dermatology最新文献

{"title":"Facial Overfilled Syndrome: A Narrative Clinical Review.","authors":"Changyang Zhou, Qilei Che, Ruonan Zhao, Haixuan Wang, Qingbiao Wa","doi":"10.2147/CCID.S600459","DOIUrl":"https://doi.org/10.2147/CCID.S600459","url":null,"abstract":"<p><strong>Background: </strong>Facial Overfilled Syndrome (FOS) is an increasingly prevalent iatrogenic complication resulting from the excessive or inappropriate use of dermal fillers. Clinically significant for causing facial distortion and unnatural dynamics, it is frequently compounded by profound psychological distress and aesthetic perception biases.</p><p><strong>Aim: </strong>This narrative clinical review aims to summarize the etiology, clinical features, diagnostic approaches, and management strategies of FOS, establishing a structured framework to emphasize the importance of prevention through anatomical knowledge and individualized treatment planning.</p><p><strong>Methods: </strong>A comprehensive literature search was conducted in PubMed, Google Scholar, and CNKI using keywords such as \"facial overfilled syndrome\", \"facial overfilling\", \"overfilled face\" and \"dermal filler complications\". Relevant original studies, clinical trials, meta-analyses, and reviews published until October 2025 were included and synthesized into a narrative framework.</p><p><strong>Results: </strong>The pathogenesis of FOS extends beyond mere volumetric excess, driven by a complex triad of anatomical mismatch, biomechanical dysregulation, and the cumulative payload of repeated treatments. Clinical hallmarks include resting distortion and unnatural facial animation. Management must be highly individualized; while targeted, ultrasound-guided hyaluronidase injection remains the established gold standard for hyaluronic acid fillers, evolving adjunctive therapies (eg, recombinant enzymes, energy-based devices, and micro-liposuction) demand strict clinical caution.</p><p><strong>Conclusion: </strong>Addressing FOS requires a clinical paradigm shift from simple volume restoration to precision-driven, layer-specific augmentation. Prevention through patient education and anatomical mastery is paramount. Future research should prioritize elucidating filler degradation kinetics, developing objective 3D assessment tools, and engineering fully reversible biomaterials.</p>","PeriodicalId":10447,"journal":{"name":"Clinical, Cosmetic and Investigational Dermatology","volume":"19 ","pages":"600459"},"PeriodicalIF":2.2,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13051189/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147632535","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Coexistence of Multiple Cutaneous Leiomyomas and Psoriasis Vulgaris: A Case Report and Review of Pathogenetic Insights.","authors":"Man Yu, Xingying Chen, Fanlin Meng, Shue Tian","doi":"10.2147/CCID.S591108","DOIUrl":"https://doi.org/10.2147/CCID.S591108","url":null,"abstract":"<p><p>The co-occurrence of multiple cutaneous leiomyomas (MCL) and psoriasis vulgaris (PV) is exceptionally rare, with no established pathophysiological link between these two conditions. We present a case of a 56-year-old woman with a 10-year history of widespread psoriatic plaques who presented with the concurrent development of multiple, firm, dark red papules and nodules. Histopathological examination confirmed the diagnosis of MCL, revealing interlacing bundles of spindle-shaped smooth muscle cells in the dermis, which were immunoreactive for smooth muscle actin and desmin. A separate biopsy from a psoriatic plaque showed characteristic features of PV. The patient was treated with a combination of thalidomide and tofacitinib, resulting in significant symptomatic and clinical improvement. This unique case highlights a potential, yet unexplored, interplay between smooth muscle proliferation and chronic inflammation, suggesting that shared immunogenetic mechanisms warrant further investigation. Clinicians should be aware of such unusual comorbidities when managing complex dermatological cases.</p>","PeriodicalId":10447,"journal":{"name":"Clinical, Cosmetic and Investigational Dermatology","volume":"19 ","pages":"591108"},"PeriodicalIF":2.2,"publicationDate":"2026-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13050168/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147621798","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bridging Accessibility and Precision: Evaluating the Reliability and Validity of a Smartphone-Based Skin Colorimeter.","authors":"Hongfei Ouyang, Jungang Yang, Xiaoli Ning, Qingyue Xia, Xianbo Zuo, Jingkai Xu, Yujun Sheng, Jinyan Song, Zitao Ma, Liang Wu, Xuejiao Song, Yong Cui","doi":"10.2147/CCID.S589014","DOIUrl":"https://doi.org/10.2147/CCID.S589014","url":null,"abstract":"<p><strong>Background: </strong>Accurate quantification of skin color is essential for dermatologic research and clinical practice. Conventional methods rely on specialized equipment, trained operators, and high costs. Smartphone-based technologies provide a promising alternative for accessible skin color assessment.</p><p><strong>Objective: </strong>To evaluate the reliability and validity of the smartphone-based skin colorimeter application, You Look Good Today (YLGTD), for facial skin color assessment compared with two validated devices, VISIA and DermaLab Combo.</p><p><strong>Methods: </strong>A total of 105 Chinese participants with healthy facial skin were enrolled. Cheek skin color measurements were obtained using YLGTD (user self-assessment and physician measurement modes), VISIA, and DermaLab Combo. Inter-rater reliability between YLGTD measurement modes was assessed using intraclass correlation coefficients (ICC) and Bland-Altman analysis. Criterion validity was evaluated using Pearson's correlation coefficients between YLGTD measurements and the reference devices.</p><p><strong>Results: </strong>YLGTD demonstrated excellent inter-rater reliability across all parameters (ICC: 0.85-0.95). Bland-Altman analysis showed small biases between the two measurement modes for the L, a, and b (-0.05, 0.18, and -0.99, respectively). For criterion validity, YLGTD in user mode showed strong correlations with DermaLab Combo for L* (r = 0.71), individual typology angle (ITA°, r = -0.81), and chroma (C*, r = 0.78), and moderate correlations for b* (r = 0.59) and hue (h°, r = 0.57). Correlations were consistently stronger in physician mode (L*: r = 0.77; b*: r = 0.75; C*: r = 0.84; ITA°: r = -0.87). VISIA showed a stronger correlation for a* (r = 0.55) but weaker correlations for L* (r = 0.56) and ITA° (r = -0.68) compared with YLGTD.</p><p><strong>Conclusion: </strong>The smartphone-based application YLGTD demonstrated excellent reliability and acceptable validity for facial skin color assessment, particularly for pigmentation-related parameters. Its standardized measurement workflow and integrated algorithms enable consistent skin color evaluation across devices and real-world conditions, providing a convenient and cost-effective approach for objective skin color assessment.</p>","PeriodicalId":10447,"journal":{"name":"Clinical, Cosmetic and Investigational Dermatology","volume":"19 ","pages":"589014"},"PeriodicalIF":2.2,"publicationDate":"2026-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13050169/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147621807","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcome of Surgical Intervention in Giant Neurofibromas in Two Sisters with Neurofibromatosis Type 1: A Case Series and Literature Review.","authors":"Huanqi Zhang, Liangliang Su, Houyi Li, Huanqian Zhang","doi":"10.2147/CCID.S581024","DOIUrl":"https://doi.org/10.2147/CCID.S581024","url":null,"abstract":"<p><p>Neurofibromatosis type I (NF1) is an autosomal dominant disorder involving the skin and nervous system. We present the surgical resection experience of two siblings with neurofibromatosis type I (NF1) and giant neurofibromas. The sisters had multiple skin discolorations and swollen areas that gradually increased in size with age. The gradually growing tumors have an impact on their lives and their quality of life. In one case, staged resection was performed following preoperative arterial embolization of the tumor. Through surgery, a tumor weighing 16 kg was removed from one sister and another weighing 11 kg from the other sister. Following surgery, both sisters demonstrated significant improvement in appearance and resumed normal daily activities. Regular follow-up visits were scheduled to monitor for recurrence or new growth.</p>","PeriodicalId":10447,"journal":{"name":"Clinical, Cosmetic and Investigational Dermatology","volume":"19 ","pages":"581024"},"PeriodicalIF":2.2,"publicationDate":"2026-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13050158/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147621772","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The IL-36 Cytokine Rheostat: Hierarchical Regulation of Epithelial-Immune Crosstalk and Precision Therapy in Psoriatic and Related Dermatoses.","authors":"Ze-Yun Qiao, Jing-Hua Liu, Na-Na Luo, Lei Tang, Wen-Yi Ma, Zi-Lin Cheng, Ping-Sheng Hao","doi":"10.2147/CCID.S594617","DOIUrl":"https://doi.org/10.2147/CCID.S594617","url":null,"abstract":"<p><p>The interleukin-36 (IL-36) cytokine subfamily-comprising IL-36α, IL-36β, IL-36γ, and their natural antagonists IL-36Ra and IL-38-has emerged as a central regulator of epithelial-immune communication and systemic inflammation. Acting through the IL-36 receptor complex (IL-1Rrp2/IL-1RAcP), IL-36 can be conceptualized as integrating protease-dependent molecular activation, multicellular amplification loops, and disease-specific network crosstalk within a unified hierarchical framework. At the molecular level, neutrophil-derived proteases license IL-36 activation, establishing a threshold that converts barrier stress into inflammatory signaling. Within cellular networks, keratinocyte-derived IL-36γ amplifies dendritic cell-Th17 interactions and neutrophil recruitment, while the antagonists IL-36Ra and IL-38 provide feedback restraint. Across the psoriatic spectrum, IL-36 acts as a driver cytokine in generalized pustular psoriasis (GPP), an amplifier in plaque psoriasis (PV), and a sustainer in psoriatic arthritis (PsA)-defining a gradient of cytokine dependency that is conceptually consistent with differential therapeutic responsiveness. Beyond psoriasis, IL-36 participates in neutrophilic, fibrosing, and atopic dermatoses, serving as a convergent inflammatory axis that bridges epithelial stress with systemic immune propagation. The successful clinical translation of IL-36R blockade-exemplified by spesolimab and imsidolimab-validates IL-36 as a tractable therapeutic target and underscores its role within the IL-17A/TNF-α/IL-23 cytokine network. Collectively, these advances position IL-36 as a cytokine rheostat capable of scaling immune intensity according to molecular and spatial context. Emerging multi-omic and spatial transcriptomic analyses are now redefining IL-36-high endotypes across inflammatory diseases, suggesting that IL-36 may serve as a reference axis for precision immunotherapy and as a conceptual model for hierarchical immune calibration in chronic inflammation.</p>","PeriodicalId":10447,"journal":{"name":"Clinical, Cosmetic and Investigational Dermatology","volume":"19 ","pages":"594617"},"PeriodicalIF":2.2,"publicationDate":"2026-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13037508/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147590439","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Combination Therapy with 308-nm Excimer Laser, Compound Glycyrrhizin, and Tacrolimus for Pediatric Facial and Cervical Vitiligo.","authors":"Yingying Qian, Yafen Wu, Wei Li, Qian Chen, Siyuan Song, Ting Zhang","doi":"10.2147/CCID.S593313","DOIUrl":"https://doi.org/10.2147/CCID.S593313","url":null,"abstract":"<p><strong>Background: </strong>Vitiligo is a common acquired depigmenting disorder in pediatric dermatology. Facial and cervical involvement is particularly distressing due to cosmetic disfigurement, leading to psychosocial impairment in children and significant psychological burden for parents. Safe and effective treatment strategies to halt disease progression and promote repigmentation are urgently needed.</p><p><strong>Objective: </strong>To evaluate the clinical efficacy, onset of repigmentation, safety, and repigmentation patterns of 308-nm excimer laser combined with oral compound glycyrrhizin and topical 0.03% tacrolimus in children with facial and cervical vitiligo.</p><p><strong>Methods: </strong>A total of 112 pediatric patients were randomized into two groups: treatment group (n=56, 86 lesions) received oral compound glycyrrhizin, topical 0.03% tacrolimus, plus 308-nm excimer laser twice weekly for 16 weeks; control group (n=56, 78 lesions) received compound glycyrrhizin and tacrolimus only. Clinical efficacy, time to initial repigmentation, adverse events, and repigmentation patterns (marginal, follicular, mixed) were assessed.</p><p><strong>Results: </strong>The overall efficacy rate was significantly higher in the treatment group (89.53%) than in controls (70.51%) (p<0.05). Initial repigmentation occurred earlier in the treatment group (face: 3.12±0.45 weeks; neck: 3.74±0.44 weeks) compared with controls (face: 4.08±0.50 weeks; neck: 4.54±0.51 weeks, both p<0.05). Adverse events were rare (3.57%) and self-limited. Repigmentation patterns differed: treatment lesions showed predominantly mixed repigmentation (65.12%), whereas controls were mainly follicular (57.69%).</p><p><strong>Conclusion: </strong>Combination therapy with 308-nm excimer laser, compound glycyrrhizin, and 0.03% tacrolimus is safe and effective for pediatric facial and cervical vitiligo, providing faster repigmentation, higher efficacy, and distinct repigmentation patterns compared with medical therapy alone.</p>","PeriodicalId":10447,"journal":{"name":"Clinical, Cosmetic and Investigational Dermatology","volume":"19 ","pages":"593313"},"PeriodicalIF":2.2,"publicationDate":"2026-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13037520/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147590447","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Refractory Morpheaform Basal Cell Carcinoma Successfully Treated with Oral Sonidegib.","authors":"Yuesen Zhang, Junyou Zheng, Xiaofang Li, Yan Wang, Fang Fang, Zhiwen Wang, Wenbo Bu","doi":"10.2147/CCID.S591343","DOIUrl":"https://doi.org/10.2147/CCID.S591343","url":null,"abstract":"<p><p>Morpheaform basal cell carcinoma (BCC) is a high-risk histologic subtype accounting for approximately 5-10% of all basal cell carcinoma cases. We report a case of facial morpheaform BCC successfully treated with oral sonidegib in a patient for whom surgery was contraindicated because of severe thrombocytopenia. A 68-year-old woman presented with an indurated sclerotic plaque with papules and crusts on the left cheek. Histopathological examination confirmed the diagnosis of morpheaform BCC. Because of the high bleeding risk associated with thrombocytopenia, surgical treatment was not considered feasible. The patient was treated with oral sonidegib at a dose of 200 mg daily, resulting in progressive regression of the lesion. After approximately two years of therapy, near-complete clinical remission was achieved, and follow-up histopathological examination with five-point sampling showed no residual tumor. This case highlights the potential role of Hedgehog pathway inhibition as an effective tissue-sparing therapeutic option for patients with difficult-to-treat morpheaform BCC.</p>","PeriodicalId":10447,"journal":{"name":"Clinical, Cosmetic and Investigational Dermatology","volume":"19 ","pages":"591343"},"PeriodicalIF":2.2,"publicationDate":"2026-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13037518/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147590407","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Breastfeeding, Family Stress, and Climate as Key Determinants of Atopic Dermatitis Severity in Children: A Cross-Sectional Study.","authors":"Amr Molla, Salman Althobaiti","doi":"10.2147/CCID.S595477","DOIUrl":"https://doi.org/10.2147/CCID.S595477","url":null,"abstract":"<p><strong>Background: </strong>Atopic dermatitis (AD) severity in children is influenced by biological, environmental, and psychosocial factors, yet severity-focused, multicenter evidence from Middle Eastern populations remains limited.</p><p><strong>Objective: </strong>To identify early-life, familial, and climatic determinants of clinical severity in pediatric AD.</p><p><strong>Methods: </strong>This multicenter cross-sectional study included 600 children diagnosed with atopic dermatitis according to the Hanifin and Rajka criteria. Disease severity was measured using the SCORAD index and categorized as mild, moderate, or severe. Independent variables included breastfeeding history, parental marital status, residential climate, animal exposure, and family atopy. Ordinal logistic regression models were used to estimate adjusted odds ratios (aORs) controlling for age, sex, and nationality.</p><p><strong>Results: </strong>Compared with bottle-feeding, breastfeeding <6 months (aOR = 0.02; 95% CI 0.007-0.079) and ≥6 months (aOR = 0.29; 95% CI 0.17-0.50) were strongly protective against greater AD severity. Children from separated/divorced or widowed households and those living in mountain regions had significantly higher severity than peers from married families and coastal areas. Cat exposure was an independent determinant of greater severity (aOR = 6.48; 95% CI 3.33-12.64) and higher SCORAD, whereas general animal exposure, consanguinity, sex, and family atopy were not significant.</p><p><strong>Conclusion: </strong>Breastfeeding, family structure, residential climate, and cat exposure are key, potentially modifiable determinants of pediatric AD severity and should inform risk-stratified, context-aware management.</p>","PeriodicalId":10447,"journal":{"name":"Clinical, Cosmetic and Investigational Dermatology","volume":"19 ","pages":"595477"},"PeriodicalIF":2.2,"publicationDate":"2026-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13037515/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147590463","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of the Effect of Laterality and Age on Pain Perception in Monopolar Radiofrequency Facial Therapy.","authors":"Ying Wang, Han Bai, Congqi Shi, Meng Wang, Shasha Zhao, Xiaodong Lai, Yan Yan","doi":"10.2147/CCID.S577283","DOIUrl":"https://doi.org/10.2147/CCID.S577283","url":null,"abstract":"<p><strong>Background: </strong>Monopolar radiofrequency (RF) is an established non-invasive modality for facial rejuvenation. Despite its proven efficacy, treatment-related pain remains a major barrier to patient compliance. Previous evidence suggests lateralized differences in pain perception, yet systematic evaluation in RF therapy is lacking.</p><p><strong>Purpose: </strong>To investigate laterality in pain perception during monopolar RF treatment and to explore the influence of age on pain sensitivity.</p><p><strong>Patients and methods: </strong>A prospective study enrolled 46 patients (45 females, 1 male; age 30-58 years) with facial laxity undergoing bilateral monopolar RF (Thermage FLX) treatment. Treatment order (left-first or right-first) was randomized, and all procedures were performed by the same right-handed physician. Pain intensity was assessed within 5 minutes post-treatment for each hemiface using a 0-10 Visual Analogue Scale (VAS, scored to one decimal place).</p><p><strong>Results: </strong>The left hemiface exhibited significantly higher VAS scores than the right (7.12 ± 2.05 vs. 6.62 ± 1.90, <i>p</i>< 0.001), irrespective of treatment order. Stratified analysis revealed that younger patients (≤42 years) reported higher VAS scores than older patients (>42 years) (left: 7.60 ± 1.46 vs. 6.64 ± 2.18; right: 7.07 ± 1.15 vs. 6.16 ± 2.17; both values of <i>p</i>< 0.05). Correlation analysis showed age was negatively associated with VAS scores.</p><p><strong>Conclusion: </strong>Monopolar RF treatment demonstrates a consistent left-side dominance in pain perception, with younger patients exhibiting greater pain sensitivity and age negatively correlated with VAS scores.</p>","PeriodicalId":10447,"journal":{"name":"Clinical, Cosmetic and Investigational Dermatology","volume":"19 ","pages":"577283"},"PeriodicalIF":2.2,"publicationDate":"2026-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13037512/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147590474","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Exposome in Melasma: A Comprehensive Review of Etiology, Mechanisms, and Implications for Management.","authors":"Wanqing Yang, Xiaoqi Meng, Tingwei Liu, Nuoran Chen, Dansheng Li, Yang Xu","doi":"10.2147/CCID.S594944","DOIUrl":"https://doi.org/10.2147/CCID.S594944","url":null,"abstract":"<p><p>Melasma is a common pigmentary skin disorder characterised by symmetrical brownish patches on the face, which significantly impacts patients' quality of life. This article provides a comprehensive review of the latest research progress on melasma from the perspective of the exposome, a dynamic interactive model. The exposome encompasses all environmental exposures and their biological responses experienced by an individual throughout their lifespan. We systematically explore the synergistic pathogenic mechanisms of endogenous exposures (such as hormonal levels, oxidative stress, thyroid dysfunction, vitamin D metabolism and psychological stress) alongside specific exogenous exposures (such as ultraviolet, visible light radiation, air pollution, pharmacological agents, dietary habits and skincare practices) and general exogenous exposures (such as climate change) in the pathogenesis of melasma. This article reveals how multiple exposure factors converge on key pathways such as the MITF/AhR signaling axis, oxidative stress cycles, and the POMC neuroendocrine pathway, collectively driving the sustained activation of melanocytes and pigmentation. Traditional therapies primarily target already formed pigmentation, with limitations including high recurrence rates and addressing symptoms rather than root causes. Based on the exposome concept, future clinical management strategies need to shift towards proactive, comprehensive health management throughout the entire process. This includes thorough assessment of individual exposure risks, enhanced full-spectrum photoprotection, skin barrier repair, lifestyle adjustments (such as stress management, regular routines and antioxidant-rich diets), as well as combined reparative treatments. This review aims to integrate existing evidence to provide new perspectives on the aetiology of melasma and offer insights for developing personalised prevention and treatment strategies.</p>","PeriodicalId":10447,"journal":{"name":"Clinical, Cosmetic and Investigational Dermatology","volume":"19 ","pages":"594944"},"PeriodicalIF":2.2,"publicationDate":"2026-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13039659/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147607566","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}