Study Reveals That Melanoma May Have Hidden Biomarkers

17AID07_Blog_SanfordHurnham_melanoma_72Melanoma is always a concern for those living in the Sunshine State. Not only are residents exposed to harmful rays year round, many older men and women retire to Florida to lay in the sun during their senior years. As Michael Steppie, M.D., assistant professor of dermatology at Florida State University, has often pointed out, the incidence of melanoma in men above the age of 65 is twice as high as the rate in women. By age 80, the rate triples. With older men being the largest high-risk group, melanoma prevention and early detection is especially important in reducing the mortality rate for this group. After all, research suggests that nearly 90 percent of melanomas could be preventable.

Dr. Steppie recently collaborated with Ranjan Perera, Ph.D., associate professor at Sanford Burnham Presbys Medical Discovery Institute at Lake Nona and other colleagues to study new biomarkers that could potentially provide earlier and more reliable clinical diagnostics for the deadliest form of skin cancer. In the past, many dermatologists warned vitiligo patients suffering from the disorder that generates white patches on their skin that they could be at a higher risk for skin cancer. It seemed to be a reasonable warning as sufferers lack the natural protection of the skin pigment melanin. However, more recent studies into the genetics of vitiligo revealed that the genes, which increase the risk of vitiligo may simultaneously decrease the person’s risk for melanoma.*

In the past, it was believed that vitiligo was an autoimmune disorder, but the research studies at Sanford Burnham Prebys have identified a microRNA called miR-211 as a possible culprit. The role of microRNAs are to prevent gene expression. Since damaged vitiligo skin cells are void of this RNA, it appears to be a disease involving abnormal cellular energy metabolism. While going from target to treatment could take time, identifying miR-211 and the genes it regulates could be promising therapeutic targets. Presently, Perera and Steppie are working to launch large -scale studies that could verify the promising findings published in the Journal of Investigative Dermatology.

As a noted Florida dermatologist and long-time advocate of melanoma prevention, Dr. Steppie offers these sun safety tips for all people who live in warm regions:

  • Remember that all skin types can develop skin cancer including people who tan easily or have naturally dark skin.
  • Generously apply sunscreen to all exposed skin — even on cloudy days — year-round.
  • Use a sunscreen that provides broad-spectrum protection from both UVA and UVB rays and has a sun protection factor (SPF) of at least 30 SPF.
  • Apply approximately one ounce of sunscreen (a shot-glassful) 15 minutes before sun exposure.
  • Reapply sunscreen every two hours and after swimming or sweating.
  • Keep newborns out of the sun. Sunscreens should be used on babies over the age of six months.
  • Wear a long-sleeved shirt, pants, a wide-brimmed hat (preferably sun-protective clothing, accessories and swimwear carrying a UPF 50+ label) and UV-Blocking sunglasses.
  • Seek shade when possible. The sun’s rays are the strongest between 10 a.m. and 4 p.m.
  • Water, snow and sand reflect and magnify the damaging rays of the sun, increasing your chance of sunburn. Especially during peak hours while at the beach, stay in the shade from an umbrella carrying a UPF 50+.
  • Avoid tanning beds – there is no way to get a tan through UV exposure without increasing the risk for skin cancer. Using a tanning bed before age 35 increases your risk for melanoma by 75 percent.
  • Be aware that certain prescription medications and over-the-counter drugs can increase your skin’s sensitivity to sunlight
  • Sun-proof your car windows with UVA-filtering window glass or film.

Source: Melanoma Research Foundation, American Academy of Dermatology

*NOTE: Having vitiligo does not mean you cannot get skin cancer, so it is very important for those with the disorder to use recommended forms of sun protection and visit his or her dermatologist for regular checkups. In addition to increasing the risk of skin cancer, sunburn can make vitiligo worse.

Dr. Steppie Sees Promising Results from Recent Vitiligo Study with Sanford Burnham Prebys

17AID07_Blog_SanfordHurnham_vitiligo72After participating in a study on vitiligo that was recently published in the Journal of Investigative Dermatology, Michael Steppie, M.D., a clinical professor of Dermatology at Florida State University College of Medicine and the President and Medical Director of Associates in Dermatology, remarked, “The promise of a treatment that cures vitiligo, rather than just dealing with the symptoms alone, is particularly exciting.”

Although vitiligo can start at any age and affects all races and both sexes equally, the white patches most often appear between twenty to thirty years of age. There is a loss of pigment in the person’s skin related to the destruction of melanocytes, which are the skin’s pigment-forming cells. Vitiligo can appear in patients of any race but is more noticeable in darker-skinned individuals. According to the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIH), the cause of vitiligo is not known but it affects about 0.5 to 1 percent of the world’s population. Vitiligo can run in families and the children of parents with the vitiligo are more likely to develop the disorder.

What causes the patches of lighter skin appear is still somewhat a mystery, which is precisely why Ranjan Perera, Ph.D., the scientific director of Analytical Genomics and Bioinformatics at Sanford Burnham Prebys, and Dr. Steppie were eager to examine new evidence. Although medical researchers have long believed the skin disorder to be associated with autoimmune disease, Perera and Steppie (along with their colleagues) may have found another culprit. Since a microRNA called miR-211 is not found vitiligo cells, it is believed the messenger RNAs may prevent gene expression by turning off several genes linked to mitochondria creation.

Although vitiligo is not life threatening, it can be life-altering causing some people to develop low self-esteem. The chronic skin disorder is usually first seen on sun-exposed areas of the face, lips, hands and feet but can progress to other body parts including the genitalia, mouth, lips, eyeball or facial hair. Although no cure exists for vitiligo, dermatologic treatments may help to slow or stop the discoloring process. Rarely does the skin get its color back but some patients have had limited color return following his or her treatment regimen. That’s why identifying miR-211 as a possible cause means this microRNA could be a promising therapeutic target.

Both Steppie and Perera are working to launch large-scale studies so the group’s recent findings can be validated and new progress made toward identifying a cure or preventing the condition in the first place. 


Skin Cancer Screenings for Melanoma Awareness Month

17AID05_Blog_skincancerscreeningAs the recurring sponsor of the daily UV Index feature on Fox 35 in Orlando, Associates in Dermatology has become well known in many of the Central Florida communities served by our 15 locations. In turn, it has become our goal to reach out to each community in hopes of saving lives through better patient outcomes for all skin cancer treatments. “The journey begins with educating key members in the community and making everyone aware of the vital role that routine screenings play in the early detection and treatment of skin cancer,” said Dr. Michael Steppie, Associates in Dermatology President and Medical Director.

May is “Melanoma Awareness Month”, a nationwide observance founded by the American Academy of Dermatology (AAD) to spread the word about the importance of early detection for the deadliest form of skin cancer. In addition to providing better sun-safety education through their community outreach programs, Associates in Dermatology is committed to providing FREE* skin cancer screenings at each location during May. With rates for both incidences and deaths continuing to rise, melanoma is a major health concern for everyone living in warmer climates like Florida.

Consider the statistical research collected by American Academy of Dermatology:

  • An estimated 161,790 new cases of melanoma will be diagnosed in 2017.
  • Melanoma affects people of every skin type.
  • On average, one American dies from melanoma every hour.
  • People with 50+ moles, atypical or large moles are at an increased risk for melanoma.
  • Before age 50, melanoma incidence rates are higher in women than men.
  • By age 65, melanoma incidence rates are twice as high in men.
  • Melanoma is the second most common form of cancer in females ages 15-29.
  • In 2017, it is estimated that 9,730 deaths will be attributed to melanoma.
  • Five-year survival rates for melanoma detected and treated early is 98 percent.
  • Each year in the U.S. over 5.4 million cases of non-melanoma skin cancer are treated in more than 3.3 million people.

In an article penned by Dr. Michael Steppie and published in the Skin Cancer Foundation Journal, about half of all melanoma skin cancer occurs in men over age 50. Melanoma is the fifth most common cancer in men and one of only three cancers with an increasing mortality rate for men. The incidence of melanoma in men ages 80 and older is three times higher than women of the same age.
Our dedication to promoting melanoma awareness and providing free skin cancer screenings each May has made Associates in Dermatology one of the most trusted sources for high quality care for those seeking skin cancer prevention and treatment. Remember skin cancer can strike anyone at any time and early detection is crucial to delivering life-saving treatments in a timely manner, so call to schedule your free skin cancer screening today.

*Offer applies to new patients. The patient and any other person responsible for payment has a right to refuse to pay, cancel payment, or be reimbursed for any other service, examination, or treatment that is performed as a result of and within 72 hours of responding to the advertisement for free, discounted fee, reduced fee service, examination or treatment. Existing patients: Free only applies to those who have not been seen in 3+ years.

Associates in Dermatology, Dr. Steppie & His Team Wish You a Happy Holiday Season and Amazing 2017


The holidays are in full swing and a brand-new year is just weeks away. As you busily shop for gifts, plan the menu for your Christmas, Hanukkah or New Year’s Eve feasts and ponder what changes and challenges 2017 will bring, Dr. Steppie and the rest of the team here at Associates in Dermatology offer a few tips for a peaceful, productive and truly happy holiday season:

  1. Embrace being perfectly imperfect: Any lifestyle mentor will tell you emphatically that perfectionism is a myth and that the pursuit of it ultimately will cost you dearly. It will only serve to cause you stress (and stress-borne wrinkles) and likely end up putting a damper on productivity anyway. So, do your best, but cut yourself some slack if every planned detail doesn’t fall into place as expected.
  2. Let go: You may already have jotted down a few New Year’s resolutions, hoping to get a mental jumpstart on your 2017 hopes and goals. But before you can make an effective plan for the new year, you must clear your path all that stands in the way physically, emotionally and otherwise. A few examples – Clear your home, office or workspace of clutter; free up your hectic schedule by learning to delegate responsibilities, to say “no” to commitments that don’t further your own goals, and to accept only those that prove truly effective and enjoyable; forgive and forget.
  3. Indulge yourself: Let’s face it – Everyday life can be hectic, whether you’re a young professional trying to jumpstart your career; a mother struggling to maintain calm in the chaos of raising children; or a retiree wondering how you’ll navigate post-career life and create a whole new reality for yourself. Keep a healthy balance to life by making sure to relax and indulge yourself regularly. Make it a non-negotiable point to take a daily walk; spend time with friends, family and pets; read a good book; travel – whatever helps you to relax, recharge and rejuvenate.

Through it all, remember that it’s critical that you guard your health, including your skin’s health as well as your hair and nails. So, start the New Year with a consultation at your nearest Associates in Dermatology location. You’ll find a team of highly experienced dermatology providers eager to help you gain and maintain your healthiest, most vibrant look. From the top of your head to the tips of your toenails, we’ve got you covered with a full array of clinical and cosmetic dermatology services.

For those of you who have been loyal Associates in Dermatology patients over the past 25 years, helping us to grow to 15 locations in six Central Florida counties, we extend our heartfelt appreciation. To all current and prospective patients, partners and friends, we wish you a peaceful and enjoyable holiday season and a prosperous 2017.