Exosome and biotherapeutic strategies for dermatological and oncological skin complications

BACKGROUND: Exosomes are nanosized extracellular vesicles (30-150 nm) that mediate intercellular communication by transferring bioactive molecules, including proteins, lipids, and nucleic acids. Their ability to regulate inflammation, immune responses, angiogenesis, and tissue regeneration has positioned them as promising candidates for the management of dermatological diseases and oncologic skin complications. METHODS: A comprehensive literature review was conducted using PubMed and Web of Science databases (2020-2025). Relevant preclinical studies, clinical trials, and mechanistic investigations evaluating exosome biology, therapeutic applications, and biotherapeutic strategies in dermatological and oncologic skin conditions were included and analysed. RESULTS: Exosome-based therapies, particularly those derived from mesenchymal and adipose-derived stem cells, demonstrate significant regenerative and immunomodulatory effects. These include enhanced wound healing, reduced inflammation, improved extracellular matrix remodelling, and modulation of immune pathways. Therapeutic benefits have been reported in chronic wounds, inflammatory dermatoses, pigmentary disorders, skin ageing, acne scarring, and treatment-related skin toxicities. In oncologic contexts, exosomes exhibit dual roles, contributing to both tissue repair and tumour progression depending on their origin. Despite strong preclinical evidence, clinical translation remains limited due to challenges in standardisation, scalability, and safety evaluation. CONCLUSIONS: Exosome-based biotherapeutics represent a promising, cell-free strategy for managing complex dermatological and oncologic skin conditions. Future progress will depend on standardised manufacturing protocols, rigorous clinical trials, and long-term safety validation to enable effective clinical application.