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. 

TO DOWNLOAD A PDF OF ABSTRACT: http://www.jidonline.org/article/S0022-202X(17)31491-4/pdf