Wenjing Li, Haiyan Li, Liangliang Fan, Ronghua Zhao, Fusong Dong, Xuxia Jia, Lijia Yin, Song Yang, Daqing Zhao, Jiawen Wang
Exosomes, owing to their potent capabilities for intercellular communication, have great potential in modern medicine. The pathogenesis of skin diseases is predominantly characterized by immune imbalance and impaired regenerative processes. Exosomes are rich in microRNAs, lipids, and proteins, which play a crucial role in immune regulation and regenerative medicine. Recent studies have highlighted the involvement of exosomes in the therapeutic management of dermatological disorders. This review provides a comprehensive overview of the potential therapeutic applications of exosomes in autoimmune skin conditions, such as systemic lupus erythematosus, systemic sclerosis, psoriasis, and vitiligo, as well as their roles in skin wound healing, skin aging, scar formation, skin flap regeneration, hair regeneration, and other skin regenerative disorders. The paper examines various exosome delivery methods and evaluates current clinical trials, identifying challenges related to exosome isolation, preservation, active components, mechanistic understanding, and clinical translation. Furthermore, it delineates future research directions and proposes innovative strategies for advancing exosome-based therapies in dermatology.