{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T10:47:19Z","timestamp":1790938039590,"version":"4.1.0"},"reference-count":62,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2022,12,27]],"date-time":"2022-12-27T00:00:00Z","timestamp":1672099200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Lasers Surg Med"],"published-print":{"date-parts":[[2023,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background and Objectives<\/jats:title><jats:p>Melasma is a refractory skin disease due to its complex pathogenesis and difficult treatment. Studies have found that human umbilical cord mesenchymal stem cell\u2010derived exosomes (hUCMSC\u2010Exos) could serve as a novel cell\u2010free therapeutic strategy in regenerative and esthetic medicine. It could potentially treat melasma, but the skin barrier is a challenge. In this study, we aim to explore the safety and efficacy of hUCMSC\u2010Exos in the treatment of melasma and the means to promote its percutaneous penetration.<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and Methods<\/jats:title><jats:p>In the animal study about the effect of penetration, percutaneous penetration of PKH67\u2010labeled hUCMSC\u2010Exos was studied under microneedles, 1565\u2009nm nonablative fractional laser (NAFL), and a plasma named Peninsula Blue Aurora Shumin Master (PBASM) treatments, observed by confocal laser scanning microscopy. In the clinical application study, 60 patients with melasma treated in our department were divided into four groups. NAFL combined with normal saline treatment was used for Group A. Microneedles, NAFL, and PBASM combined with hUCMSC\u2010Exos treatments were used for Groups B, C, and D, respectively. Each patient received four treatments at 1\u2010month intervals. Assessments were done using the degree of pain posttreatment, melasma area and severity score, improvement rate, physician global assessment score, satisfaction, and complications.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In the animal study about the effect of penetration, hUCMSC\u2010Exos can penetrate the deep dermis under microneedles, NAFL, and PBASM treatments. In the clinical application study, compared with Group A, Groups B, C, and D showed significantly improved therapeutic effect and patient satisfaction (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05), and there was no significant difference among Groups B, C, and D.(<jats:italic>p<\/jats:italic>\u2009&gt;\u20090.05). Patients in Group B reported higher pain levels than those in the other three groups (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05); the treatment experience of patients in Group D was better.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>hUCMSC\u2010Exos can improve the symptoms of melasma safely and effectively. Compared with microneedles, NAFL and PBASM can also achieve a good effect toward promoting penetration. These findings are worthy of exploration and clinical application.<\/jats:p><\/jats:sec>","DOI":"10.1002\/lsm.23628","type":"journal-article","created":{"date-parts":[[2022,12,27]],"date-time":"2022-12-27T10:15:40Z","timestamp":1672136140000},"page":"178-189","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":41,"title":["Stem cell\u2010derived exosomes in the treatment of melasma and its percutaneous penetration"],"prefix":"10.1002","volume":"55","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8542-3667","authenticated-orcid":false,"given":"Ting","family":"Wang","sequence":"first","affiliation":[{"name":"Department of Plastic Surgery and Regenerative Medicine Fujian Medical University Union Hospital  Fuzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hangqi","family":"Gao","sequence":"additional","affiliation":[{"name":"Department of Plastic Surgery and Regenerative Medicine Fujian Medical University Union Hospital  Fuzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dezhi","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Plastic Surgery and Regenerative Medicine Fujian Medical University Union Hospital  Fuzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chaoyu","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Plastic Surgery and Regenerative Medicine Fujian Medical University Union Hospital  Fuzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kailun","family":"Hu","sequence":"additional","affiliation":[{"name":"Department of Plastic Surgery and Regenerative Medicine Fujian Medical University Union Hospital  Fuzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haoruo","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Plastic Surgery and Regenerative Medicine Fujian Medical University Union Hospital  Fuzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jian","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Plastic Surgery and Regenerative Medicine Fujian Medical University Union Hospital  Fuzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaosong","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Plastic Surgery and Regenerative Medicine Fujian Medical University Union Hospital  Fuzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,12,27]]},"reference":[{"key":"e_1_2_8_2_1","first-page":"13","article-title":"Current concepts in melasma \u2010 a review article","volume":"2","author":"Aishwarya K","year":"2020","journal-title":"J Skin Sex Trans Dis"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10103-022-03514-2"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/lsm.23032"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/lsm.23474"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/dth.13503"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/lsm.23312"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jid.2020.03.777"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jid.2021.07.167"},{"key":"e_1_2_8_10_1","first-page":"22","article-title":"Differential therapeutic effect of extracellular vesicles derived by bone marrow and adipose mesenchymal stem cells on wound healing of diabetic ulcers and correlation to their cargoes","author":"Pomatto M","year":"2021","journal-title":"Int J Mol Sci"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12015-020-09992-7"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jphs.2021.06.008"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bbrc.2017.09.056"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1080\/20013078.2019.1703480"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.3390\/cells9051157"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/php.13370"},{"key":"e_1_2_8_17_1","unstructured":"Wenliping. 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