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Comparative Study
. 2024 May 11;23(1):138.
doi: 10.1186/s12944-024-02130-z.

Comparative study of melasma in patients before and after treatment based on lipomics

Yuan Zhu  1 , Jinhui Xu  1 , Xiuzu Song  1 , Wenzhong Xiang  2
Affiliations
Comparative Study

Comparative study of melasma in patients before and after treatment based on lipomics

Yuan Zhu et al. Lipids Health Dis. .

Abstract

Background: Skin barrier alterations play a crucial function in melasma development. Past researches have demonstrated variations in lipid content between the epidermis of melasma lesions and normal tissues, along with the varied expression of lipid-related genes in melasma. This study aimed to analyze the lipidome profiles of skin surface lipids (SSL) in patients with melasma before and after treatment to understand associated abnormalities.

Methods: Melasma was treated with tranexamic acid orally and hydroquinone cream topically. Disease was assessed using the Melasma Area and Severity Index (MASI), and the impact to life was evaluated with Melasma Quality of Life (MELASQoL) score. Epidermal melanin particles were observed using reflection confocal microscopy (RCM), whereas epidermal pigment and blood vessel morphology were observed using dermoscopy, and SSL samples were collected. Specific information regarding alterations in lipid composition was obtained through multivariate analysis of the liquid chromatography-mass spectrometry data.

Results: After treatment, patients with melasma exhibited decreased MASI and MELASQoL scores (P < 0.001); RCM revealed reduced melanin content in the lesions, and dermoscopy revealed fewer blood vessels. Fifteen lipid subclasses and 382 lipid molecules were identified using lipidomic assays. The expression levels of total lipids, phosphatidylcholine, and phosphatidylethanolamine in the melasma lesions decreased after treatment (P < 0.05).

Conclusion: This study revealed alterations in the SSL composition after effective melasma treatment, suggesting a compensatory role for lipids in melasma barrier function. The mechanism involving SSL and the lipid barrier, which influences melasma's occurrence, needs further elucidation.

Keywords: Lipidomics; Melasma; Melasma area and severity index.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
(A) Changes in Melasma Area and Severity Index (MASI) across different periods. (B) Changes in Melasma Quality of Life (MELASQoL) scores of patients across different periods. *** P < 0.001
Fig. 2
Fig. 2
reflection confocal microscopy (RCM) and Dermoscopic images of normal facial skin and images before and after treatment of melasma with oral tranexamic acid (TXA) and topical hydroquinone (HQ) cream. (A) A normal facial RCM image (×30); (B) RCM image of melasma lesions at T0 (×30, the red arrows represent melanin particles and the white arrows represent melanin cells): the melanin content in the stratum corneum and basal layer of the lesions significantly increased compared to that of (A); (C) Dendritic cells in melasma lesions at T0 (×30, the white arrows represent dendritic cells); (D) RCM image of the melasma lesion area at T2 show that the melanin content was reduced compared to that at T0 (B), and no obvious dendritic cells are observed (×30); (E) Dermoscopic image of a normal face (×20); (F) Dermoscopic image of melasma lesions at T0 (×20): Uniform yellow–brown patches can be seen, with honeycomb or reticular distribution and linear or dendritic capillary networks; (G) Dermoscopic image of the melasma lesion area at T2 (×20): the color of the spots in the tan background is lighter than that in (F), and blood vessels are thinned and reduced in number (F and G originated from the same patients, E originated from healthy control)
Fig. 3
Fig. 3
Multivariate data analysis of lipids before and after melasma treatment. (A) Scoring plot of OPLS-DA depicting the molecular variations between T0 and T1 lipids in melasma patients. (B) Heat map of 34 lipid species (P < 0.05; VIP > 1; Drawn in R language, visualized based on ggplot2). Differential color blocks placed at various locations signify the relative abundance of lipid molecules at those specific locations. A shade of red denotes higher expression levels, while a shade of green indicates lower expression levels. Lipid molecules displaying analogous expression profiles are grouped together in the same category on the left side. (C) Correlation matrix depicting the relationships between 34 lipid species (P < 0.05; VIP > 1; Drawn in R language, visualized based on ggplot2). The color scale ranges from red to blue, where red denotes a positive correlation and blue a negative one. The intensity of the color corresponds to the magnitude of the correlation coefficient’s absolute value. (D) Graphical representation of the network involving 34 lipid species (P < 0.05; VIP > 1; Visualized by Cytoscape Version 3.8.2). (E) and (F) represent the content changes of different lipid subclasses in lipidomics tests
Fig. 4
Fig. 4
Comparison of the expression profiles of total lipids and certain lipid classes prior to and following melasma treatment. (A), (B), (C), (D), (E), and (F) show the comparison of total lipids, phosphatidylcholine (PC), phosphatidylethanolamine (PE), triglyceride (TG), fatty acid (FA), and ceramide (CER) content before and after treatment, respectively. After 3 weeks of treatment with oral TXA and topical HQ cream, the expression of total lipids, PC, and PE in the skin was significantly reduced (*P < 0.05), and the expression of TG, FA, and CER decreased, but not significantly (ns P > 0.05)
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