性激素在黄褐斑发病中的作用及机制

doi:10.35541/cjd.20240643

Abstract

Abstract: 【Abstract】 In recent years, growing evidence has suggested a strong correlation between the development of melasma and abnormal endocrine hormone levels, particularly sex hormones. This review summarizes clinical data on sex hormone profiles in melasma patients from previous studies, analyzes the roles of various hormones in pigmentation and the pathogenesis of melasma, and investigates their clinical significance as well as directions for future research.

Key words: Melasma, Sex hormones, Endocrine system, Pathogenesis

He Muyang, Jin Shanglin, Zhang Chengfeng. Roles of sex hormones and underlying mechanisms in the pathogenesis of melasma[J]. Chinese Journal of Dermatology, 2025, 58(9): 863-867.doi:10.35541/cjd.20240643

References ［56］

［1］	Chen W, Wan Y, Sun Y, et al. Prevalence of depression in melasma: a systematic review and meta⁃analysis［J］. Front Psychiatry, 2023,14:1276906. doi: 10.3389/fpsyt.2023.1276906.
［2］	王庭槐. 生理学［M］. 第9版. 北京: 人民卫生出版社, 2018.
［3］	Farag MM, Basha MA, Azmy RM. A study on the effect of estrogen, progesterone, and their cutaneous receptors in the pathogenesis of melisma［J］. Menoufia Med J, 2016,29（2）:389.
［4］	Gopichandani K, Arora P, Garga U, et al. Hormonal profile of melasma in Indian females［J］. Pigment Int, 2015,2（2）:85⁃90.
［5］	Mahmood K, Nadeem M, Aman S, et al. Role of estrogen, progesterone and prolactin in the etiopathogenesis of melasma in females［J］. J Pak Assoc Dermatol, 2011, 21（4）:241⁃247. https://jpad.com.pk/index.php/jpad/article/view/483.
［6］	Adalatkhah H, Amani F. The correlation between melasma, ovarian cysts and androgenic hormones （a case⁃control study）［J］. Res Biol Sci, 2007, 2:593⁃596.
［7］	Hassan I, Kaur I, Sialy R, et al. Hormonal milieu in the maintenance of melasma in fertile women［J］. J Dermatol, 1998,25（8）:510⁃512. doi: 10.1111/j.1346⁃8138.1998.tb02445.x.
［8］	万苗坚, 赵广, 蔡瑞康, 等. 黄褐斑患者血清性激素水平的研究［J］. 中华皮肤科杂志, 1997,30（6）:403⁃404.
［9］	Pérez M, Sánchez JL, Aguiló F. Endocrinologic profile of patients with idiopathic melasma［J］. J Invest Dermatol, 1983,81（6）:543⁃545. doi: 10.1111/1523⁃1747.ep12522896.
［10］	Platsidaki E, Markantoni V, Nicolaidou E, et al. Melasma: a clinical and epidemiological single⁃group observational study in the greek population［J］. Dermatol Ther （Heidelb）, 2024,14（11）:3183⁃3192. doi: 10.1007/s13555⁃024⁃01297⁃8.
［11］	Getachew ED, Kamal K, Young K, et al. A case⁃control study of racial differences in melasma risk factors and incidence in a diverse national United States population［J］. J Am Acad Dermatol, 2024,91（3）:539⁃541. doi: 10.1016/j.jaad.2024.04.068.
［12］	Sialy R, Hassan I, Kaur I, et al. Melasma in men: a hormonal profile［J］. J Dermatol, 2000,27（1）:64⁃65. doi: 10.1111/j.1346⁃8138.2000.tb02122.x.
［13］	Nukana RP, Rusyati LMM, Praharsini GAA, et al. Association of testosterone level with melasma in men: a case⁃control study in indonesia［J］. Pan Afr Med J, 2022,43（1）:194. doi: 10.11604/pamj.2022.43.194.37435.
［14］	Handa S, De D, Khullar G, et al. The clinicoaetiological, hormonal and histopathological characteristics of melasma in men［J］. Clin Exp Dermatol, 2018,43（1）:36⁃41. doi: 10.1111/ced. 13234.
［15］	Sarkar R, Puri P, Jain RK, et al. Melasma in men: a clinical, aetiological and histological study［J］. J Eur Acad Dermatol Venereol, 2010,24（7）:768⁃772. doi: 10.1111/j.1468⁃3083. 2009.03524.x.
［16］	Martin AG, Leal⁃Khouri S. Physiologic skin changes associated with pregnancy［J］. Int J Dermatol, 1992,31（6）:375⁃378. doi: 10.1111/j.1365⁃4362.1992.tb02662.x.
［17］	Handel AC, Lima PB, Tonolli VM, et al. Risk factors for facial melasma in women: a case⁃control study［J］. Br J Dermatol, 2014,171（3）:588⁃594. doi: 10.1111/bjd.13059.
［18］	Ortonne JP, Arellano I, Berneburg M, et al. A global survey of the role of ultraviolet radiation and hormonal influences in the development of melasma［J］. J Eur Acad Dermatol Venereol, 2009,23（11）:1254⁃1262. doi: 10.1111/j.1468⁃3083.2009.03295.x.
［19］	Sarkar R, Jagadeesan S, Basavapura Madegowda S, et al. Clinical and epidemiologic features of melasma: a multicentric cross⁃sectional study from India［J］. Int J Dermatol, 2019,58（11）:1305⁃1310. doi: 10.1111/ijd.14541.
［20］	Tamega Ade A, Miot LD, Bonfietti C, et al. Clinical patterns and epidemiological characteristics of facial melasma in Brazilian women［J］. J Eur Acad Dermatol Venereol, 2013,27（2）:151⁃156. doi: 10.1111/j.1468⁃3083.2011.04430.x.
［21］	Guinot C, Cheffai S, Latreille J, et al. Aggravating factors for melasma: a prospective study in 197 Tunisian patients［J］. J Eur Acad Dermatol Venereol, 2010,24（9）:1060⁃1069. doi: 10.1111/j.1468⁃3083.2010.03592.x.
［22］	Passeron T, Picardo M. Melasma, a photoaging disorder［J］. Pigment Cell Melanoma Res, 2018,31（4）:461⁃465. doi: 10.1111/pcmr.12684.
［23］	Kagha K, Fabi S, Goldman MP. Melasma′s impact on quality of life［J］. J Drugs Dermatol, 2020,19（2）:184⁃187. doi: 10.36849/JDD.2020.4663.
［24］	Handel AC, Miot LD, Miot HA. Melasma: a clinical and epidemiological review［J］. An Bras Dermatol, 2014,89（5）:771⁃782. doi: 10.1590/abd1806⁃4841.20143063.
［25］	Espósito A, Cassiano DP, da Silva CN, et al. Update on melasma⁃part Ⅰ: pathogenesis［J］. Dermatol Ther （Heidelb）, 2022,12（9）:1967⁃1988. doi: 10.1007/s13555⁃022⁃00779⁃x.
［26］	Poisson. Chloasma in a man with total hypogonadism［J］. Bull Soc Fr Dermatol Syphiligr, 1957, 64（5）:777⁃778. https://europepmc.org/article/MED/13536740.
［27］	Cheng D, Gaurav A, Xiang D, et al. Hormonal intrauterine devices are associated with lower long⁃term melasma risk compared with combined and progestin⁃only oral contraceptives: a population⁃based Cohort study［J］. J Am Acad Dermatol, 2025,93（2）:473⁃475. doi: 10.1016/j.jaad.2025.04.040.
［28］	Johnston GA, Sviland L, McLelland J. Melasma of the arms associated with hormone replacement therapy［J］. Br J Dermatol, 1998,139（5）:932. doi: 10.1046/j.1365⁃2133.1998.02537.x.
［29］	Burkhart CG. Chloasma in a man due to oral hormone replacement［J］. Skinmed, 2006,5（1）:46⁃47. doi: 10.1111/j.1540⁃9740.2006.04323.x.
［30］	Famenini S, Gharavi NM, Beynet DP. Finasteride associated melasma in a Caucasian male［J］. J Drugs Dermatol, 2014,13（4）:484⁃486. https://jddonline.com/articles/finasteride⁃associated⁃melasma⁃in⁃a⁃caucasian⁃male⁃S1545961614P0484X.
［31］	Ogita A, Funasaka Y, Ansai S, et al. Melasma in a male patient due to estrogen therapy for prostate cancer［J］. Ann Dermatol, 2015,27（6）:763⁃764. doi: 10.5021/ad.2015.27.6.763.
［32］	Filoni A, Mariano M, Cameli N. Melasma: how hormones can modulate skin pigmentation［J］. J Cosmet Dermatol, 2019,18（2）:458⁃463. doi: 10.1111/jocd.12877.
［33］	Catalano S, Giordano C, Panza S, et al. Tamoxifen through GPER upregulates aromatase expression: a novel mechanism sustaining tamoxifen⁃resistant breast cancer cell growth［J］. Breast Cancer Res Treat, 2014,146（2）:273⁃285. doi: 10.1007/s10549⁃014⁃3017⁃4.
［34］	Snyder A, Schiechert RA, Zaiac MN. Melasma associated with topical estrogen cream［J］. J Clin Aesthet Dermatol, 2017,10（2）:57⁃58.
［35］	Mahjour M, Khoushabi A, Feyzabadi Z. The role of oligomenorrhea in melasma［J］. Med Hypotheses, 2017,104:1⁃3. doi: 10.1016/j.mehy.2017.05.006.
［36］	Caerts D, Garmyn M, Güvenç C. A narrative review of the role of estrogen （receptors） in melanoma［J］. Int J Mol Sci, 2024,25（11）:6251. doi: 10.3390/ijms25116251.
［37］	唐建兵, 柳大烈, 程飚, 等. 黄褐斑皮损中雌激素受体β的表达分析［J］. 中华皮肤科杂志, 2010,43（12）:873⁃874.
［38］	Kippenberger S, Loitsch S, Solano F, et al. Quantification of tyrosinase, TRP⁃1, and Trp⁃2 transcripts in human melanocytes by reverse transcriptase⁃competitive multiplex PCR⁃⁃regulation by steroid hormones［J］. J Invest Dermatol, 1998,110（4）:364⁃367. doi: 10.1038/jid.1998.1.
［39］	Im S, Lee ES, Kim W, et al. Donor specific response of estrogen and progesterone on cultured human melanocytes［J］. J Korean Med Sci, 2002,17（1）:58⁃64. doi: 10.3346/jkms.2002.17.1.58.
［40］	Wiedemann C, Nägele U, Schramm G, et al. Inhibitory effects of progestogens on the estrogen stimulation of melanocytes in vitro［J］. Contraception, 2009,80（3）:292⁃298. doi: 10.1016/j.contraception.2009.03.005.
［41］	Orme ML, Back DJ, Ball S. Interindividual variation in the metabolism of ethynylestradiol［J］. Pharmacol Ther, 1989,43（2）:251⁃260. doi: 10.1016/0163⁃7258（89）90121⁃6.
［42］	Gauthier Y, Cario M, Pain C, et al. Oestrogen associated with ultraviolet B irradiation recapitulates the specific melanosome distribution observed in Caucasoid melasma［J］. Br J Dermatol, 2019,180（4）:951⁃953. doi: 10.1111/bjd.17453.
［43］	Kim NH, Cheong KA, Lee TR, et al. PDZK1 upregulation in estrogen⁃related hyperpigmentation in melasma［J］. J Invest Dermatol, 2012,132（11）:2622⁃2631. doi: 10.1038/jid.2012.175.
［44］	Sun M, Xie HF, Tang Y, et al. G protein⁃coupled estrogen receptor enhances melanogenesis via cAMP⁃protein kinase （PKA） by upregulating microphthalmia⁃related transcription factor⁃tyrosinase in melanoma［J］. J Steroid Biochem Mol Biol, 2017,165（Pt B）:236⁃246. doi: 10.1016/j.jsbmb.2016.06.012.
［45］	Natale CA, Duperret EK, Zhang J, et al. Sex steroids regulate skin pigmentation through nonclassical membrane⁃bound receptors［J］. Elife, 2016,5:e15104. doi: 10.7554/eLife.15104.
［46］	徐斌, 刘小明. 雌二醇对黑素细胞Wnt5A、ROR2及β⁃catenin表达的影响［J］. 中国麻风皮肤病杂志, 2015,31（1）:3⁃4.
［47］	Kang HY, Suzuki I, Lee DJ, et al. Transcriptional profiling shows altered expression of Wnt pathway⁃ and lipid metabolism⁃related genes as well as melanogenesis⁃related genes in melasma［J］. J Invest Dermatol, 2011,131（8）:1692⁃1700. doi: 10.1038/jid. 2011.109.
［48］	Scott MC, Suzuki I, Abdel⁃Malek ZA. Regulation of the human melanocortin 1 receptor expression in epidermal melanocytes by paracrine and endocrine factors and by ultraviolet radiation［J］. Pigment Cell Res, 2002,15（6）:433⁃439. doi: 10.1034/j.1600⁃0749.2002.02051.x.
［49］	Huber J, Gruber C. Immunological and dermatological impact of progesterone［J］. Gynecol Endocrinol, 2001,15（Suppl 6）:18⁃21. doi: 10.1080/gye.15.s6.18.21.
［50］	Gasser S, Heidemeyer K, von Wolff M, et al. Impact of progesterone on skin and hair in menopause ⁃ a comprehensive review［J］. Climacteric, 2021,24（3）:229⁃235. doi: 10.1080/13697137.2020.1838476.
［51］	Tamega Ade A, Miot HA, Moço NP, et al. Gene and protein expression of oestrogen⁃β and progesterone receptors in facial melasma and adjacent healthy skin in women［J］. Int J Cosmet Sci, 2015,37（2）:222⁃228. doi: 10.1111/ics.12186.
［52］	Jang YH, Lee JY, Kang HY, et al. Oestrogen and progesterone receptor expression in melasma: an immunohistochemical analysis［J］. J Eur Acad Dermatol Venereol, 2010,24（11）:1312⁃1316. doi: 10.1111/j.1468⁃3083.2010.03638.x.
［53］	Maeda K, Naganuma M, Fukuda M, et al. Effect of pituitary and ovarian hormones on human melanocytes in vitro［J］. Pigment Cell Res, 1996,9（4）:204⁃212. doi: 10.1111/j.1600⁃0749.1996.tb00110.x.
［54］	Hall AM, Krishnamoorthy L, Orlow SJ. Accumulation of tyrosinase in the endolysosomal compartment is induced by U18666A［J］. Pigment Cell Res, 2003,16（2）:149⁃158. doi: 10. 1034/j.1600⁃0749.2003.00027.x.
［55］	Maeda K, Naganuma M, Fukuda M, et al. Effect of pituitary and ovarian hormones on human melanocytes in vitro［J］. Pigment Cell Res, 1996,9（4）:204⁃212. doi: 10.1111/j.1600⁃0749.1996.tb00110.x.
［56］	Tadokoro T, Rouzaud F, Itami S, et al. The inhibitory effect of androgen and sex⁃hormone⁃binding globulin on the intracellular cAMP level and tyrosinase activity of normal human melanocytes［J］. Pigment Cell Res, 2003,16（3）:190⁃197. doi: 10.1034/j.1600⁃0749.2003.00019.x.

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Roles of sex hormones and underlying mechanisms in the pathogenesis of melasma

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