Activated melanocytes and senescent collagen fibers predict laser-treated melasma outcomes: An optical biopsy–based prospective cohort study

Background: Melasma Area and Severity Index (MASI) score only assesses the pigmentation rather than photoaging. Picosecond alexandrite laser (PAL) with diffractive lens array (DLA) can improve photoaging and has been approved for melasma treatment. Prediction for post-laser outcome is limited. Objec...

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Main Authors: Yen-Jen Wang, Chang-Cheng Chang, Yu-Hung Wu, Ling Huang, I-Ling Chen, Yu-Chang Shih, Hsing Cheng, Jia-Wei Shen, Meng-En Lu, Hsiu-Mei Chiang, Bor-Shyh Lin
Format: Article
Language:English
Published: Elsevier 2025-08-01
Series:Photodiagnosis and Photodynamic Therapy
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Online Access:http://www.sciencedirect.com/science/article/pii/S1572100025001802
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author Yen-Jen Wang
Chang-Cheng Chang
Yu-Hung Wu
Ling Huang
I-Ling Chen
Yu-Chang Shih
Hsing Cheng
Jia-Wei Shen
Meng-En Lu
Hsiu-Mei Chiang
Bor-Shyh Lin
author_facet Yen-Jen Wang
Chang-Cheng Chang
Yu-Hung Wu
Ling Huang
I-Ling Chen
Yu-Chang Shih
Hsing Cheng
Jia-Wei Shen
Meng-En Lu
Hsiu-Mei Chiang
Bor-Shyh Lin
author_sort Yen-Jen Wang
collection DOAJ
description Background: Melasma Area and Severity Index (MASI) score only assesses the pigmentation rather than photoaging. Picosecond alexandrite laser (PAL) with diffractive lens array (DLA) can improve photoaging and has been approved for melasma treatment. Prediction for post-laser outcome is limited. Objective: To in vivo compare the photoaging milieu altered by a PAL with DLA in melasma lesions and adjacent perilesions, and to delineate the predictive factors for outcomes. Methods: An optical biopsy with cellular resolution full-field optical coherence tomography (CRFF-OCT) was set up to evaluate the dynamic changes. Quantification was performed with the computer-aided detection (CADe) system. Results: The mean MASI score decreased significantly (p < 0.001) in 12 of 15 patients but increased in the other three. An optical biopsy of 74,340 images showed the numbers of activated melanocytes and melanophages were significantly reduced post laser, and the basement membrane (BM) was repaired in melasma lesions, while basal lightening was noted in perilesions. The pre-treatment presence of activated melanocytes was associated with a high regional MASI score (p = 0.013), while the senescent collagen fibers and activated melanocyte patterns were associated with less MASI score improvement (p = 0.005). Senescent collagen fibers (p = 0.002) and baseline BM damage(p = 0.001) were strongly correlated to post-treatment melanophages. The baseline MASI score was not associated with activated melanocyte status or treatment outcomes. Conclusion: Optical biopsy using CRFF-OCT revealed that patterns of activated melanocytes and senescent collagen fibers can serve as predictive markers for post-laser treatment outcomes. The photoaging characteristics of melasma were improved through the reduction of activated melanocytes and the repair of the BM.
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spelling doaj-art-adc54a6b66a74238b9b7a2cb867bb9402025-08-20T03:44:58ZengElsevierPhotodiagnosis and Photodynamic Therapy1572-10002025-08-015410464810.1016/j.pdpdt.2025.104648Activated melanocytes and senescent collagen fibers predict laser-treated melasma outcomes: An optical biopsy–based prospective cohort studyYen-Jen Wang0Chang-Cheng Chang1Yu-Hung Wu2Ling Huang3I-Ling Chen4Yu-Chang Shih5Hsing Cheng6Jia-Wei Shen7Meng-En Lu8Hsiu-Mei Chiang9Bor-Shyh Lin10Department of Dermatology, MacKay Memorial Hospital, Taipei, Taiwan; Department of Cosmetic Applications and Management, MacKay Junior College of Medicine, Nursing, and Management, New Taipei City, TaiwanDepartment of Cosmeceutics, China Medical University, Taichung, Taiwan; Institute of Imaging and Biomedical Photonics, National Yang Ming Chiao Tung University, Tainan, Taiwan; School of medicine, College of medicine, China medical university, China Medical University Hospital, Taichung, Taiwan; Aesthetic medical center, China Medical University Hospital, Taichung, Taiwan; Corresponding author.Department of Dermatology, MacKay Memorial Hospital, Taipei, Taiwan; Department of Medicine, Mackay Medical College, New Taipei City, TaiwanApollo Medical Optics Ltd., Taipei, TaiwanApollo Medical Optics Ltd., Taipei, TaiwanApollo Medical Optics Ltd., Taipei, TaiwanApollo Medical Optics Ltd., Taipei, TaiwanDepartment of Cosmeceutics, China Medical University, Taichung, TaiwanDepartment of Cosmeceutics, China Medical University, Taichung, TaiwanDepartment of Cosmeceutics, China Medical University, Taichung, TaiwanInstitute of Imaging and Biomedical Photonics, National Yang Ming Chiao Tung University, Tainan, TaiwanBackground: Melasma Area and Severity Index (MASI) score only assesses the pigmentation rather than photoaging. Picosecond alexandrite laser (PAL) with diffractive lens array (DLA) can improve photoaging and has been approved for melasma treatment. Prediction for post-laser outcome is limited. Objective: To in vivo compare the photoaging milieu altered by a PAL with DLA in melasma lesions and adjacent perilesions, and to delineate the predictive factors for outcomes. Methods: An optical biopsy with cellular resolution full-field optical coherence tomography (CRFF-OCT) was set up to evaluate the dynamic changes. Quantification was performed with the computer-aided detection (CADe) system. Results: The mean MASI score decreased significantly (p < 0.001) in 12 of 15 patients but increased in the other three. An optical biopsy of 74,340 images showed the numbers of activated melanocytes and melanophages were significantly reduced post laser, and the basement membrane (BM) was repaired in melasma lesions, while basal lightening was noted in perilesions. The pre-treatment presence of activated melanocytes was associated with a high regional MASI score (p = 0.013), while the senescent collagen fibers and activated melanocyte patterns were associated with less MASI score improvement (p = 0.005). Senescent collagen fibers (p = 0.002) and baseline BM damage(p = 0.001) were strongly correlated to post-treatment melanophages. The baseline MASI score was not associated with activated melanocyte status or treatment outcomes. Conclusion: Optical biopsy using CRFF-OCT revealed that patterns of activated melanocytes and senescent collagen fibers can serve as predictive markers for post-laser treatment outcomes. The photoaging characteristics of melasma were improved through the reduction of activated melanocytes and the repair of the BM.http://www.sciencedirect.com/science/article/pii/S1572100025001802Basement membraneCollagenMelanocytesMelasmaOptical coherence tomography
spellingShingle Yen-Jen Wang
Chang-Cheng Chang
Yu-Hung Wu
Ling Huang
I-Ling Chen
Yu-Chang Shih
Hsing Cheng
Jia-Wei Shen
Meng-En Lu
Hsiu-Mei Chiang
Bor-Shyh Lin
Activated melanocytes and senescent collagen fibers predict laser-treated melasma outcomes: An optical biopsy–based prospective cohort study
Photodiagnosis and Photodynamic Therapy
Basement membrane
Collagen
Melanocytes
Melasma
Optical coherence tomography
title Activated melanocytes and senescent collagen fibers predict laser-treated melasma outcomes: An optical biopsy–based prospective cohort study
title_full Activated melanocytes and senescent collagen fibers predict laser-treated melasma outcomes: An optical biopsy–based prospective cohort study
title_fullStr Activated melanocytes and senescent collagen fibers predict laser-treated melasma outcomes: An optical biopsy–based prospective cohort study
title_full_unstemmed Activated melanocytes and senescent collagen fibers predict laser-treated melasma outcomes: An optical biopsy–based prospective cohort study
title_short Activated melanocytes and senescent collagen fibers predict laser-treated melasma outcomes: An optical biopsy–based prospective cohort study
title_sort activated melanocytes and senescent collagen fibers predict laser treated melasma outcomes an optical biopsy based prospective cohort study
topic Basement membrane
Collagen
Melanocytes
Melasma
Optical coherence tomography
url http://www.sciencedirect.com/science/article/pii/S1572100025001802
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