Terapi Eksosom pada Melasma: Bukti Baru dan Aplikasi Klinis: Terapi Eksosom pada Melasma: Bukti Baru dan Aplikasi Klinis

Joice Rumondang; Nelva Karmila Jusuf

doi:10.33820/mdvi.v53i3.565

Authors

Joice Rumondang FK USU https://orcid.org/0009-0009-8214-2478
Nelva Karmila Jusuf Program Studi dan Departemen Dermatologi Venereologi dan Estetika Fakultas Kedokteran Universitas Sumatera Utara https://orcid.org/0000-0002-9798-3941

DOI:

https://doi.org/10.33820/mdvi.v53i3.565

Keywords:

eksosom, hiperpigmentasi, melasma, sel punca mesenkimal

Abstract

Melasma merupakan gangguan hiperpigmentasi kronis pada wajah dan banyak ditemukan pada wanita dengan warna kulit lebih gelap. Melasma menjadi tantangan klinis karena patogenesisnya multifaktorial, respons terhadap terapi bervariasi, dan kekambuhan sering terjadi. Iritasi akibat modalitas terapi dapat meningkatkan risiko hiperpigmentasi pascainflamasi, sehingga diperlukan terapi tambahan yang menargetkan mekanisme patogenesis. Eksosom, terutama yang berasal dari sel punca mesenkimal, membawa molekul bioaktif yang memodulasi melanogenesis, inflamasi, stres oksidatif, dan homeostasis melanosom. Tinjauan pustaka ini bertujuan mengevaluasi peran dan bukti efektivitas eksosom pada melasma. Pencarian dilakukan melalui PubMed/MEDLINE, Scopus, dan Google Scholar terhadap publikasi 2021–2025 menggunakan kata kunci exosome, extracellular vesicle, melasma, melanogenesis, skin pigmentation, dan hyperpigmentation. Sebanyak 23 artikel digunakan, meliputi penelitian praklinis, klinis, dan tinjauan. Bukti praklinis menunjukkan modulasi melanogenesis melalui MITF, tirosinase, TYRP1/TYRP2, serta degradasi dan transport melanosom. Bukti klinis masih terbatas; studi Wang dkk. dan Proietti dkk. menunjukkan perbaikan pigmentasi setelah kombinasi eksosom dengan prosedur penghantaran. Namun, ukuran sampel kecil, heterogenitas produk dan metode penghantaran, serta keterbatasan follow-up membatasi interpretasi hasil. Eksosom berpotensi sebagai terapi tambahan, tetapi diperlukan penelitian dengan standardisasi produk dan follow-up jangka panjang.

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Author Biographies

Joice Rumondang, FK USU

Department of Dermatology and Venereology, Resident

Nelva Karmila Jusuf, Program Studi dan Departemen Dermatologi Venereologi dan Estetika Fakultas Kedokteran Universitas Sumatera Utara

Department of Dermatology and Venreology, Head Division Dermatology Cosmetic

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TERAPI EKSOSOM PADA MELASMA: BUKTI TERKINI DAN APLIKASI KLINIS