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Dermatology

Cancer, Dermatology, Public Health, Research

Skin cancer images help people check skin more often and effectively

Skin cancer images help people check skin more often and effectively

skin pointIf I told you that people are more inclined to look for something when they’ve actually seen what they’re looking for, you probably wouldn’t be that surprised. Yet, this is important information for medical professionals who want to motivate their patients to examine their own skin for signs of cancer. In new research, people who were shown images of skin cancer were more likely to examine their skin than people who’d only read about it.

Graduate student Jennifer E. McWhirter, BSc, and professor Laurie Hoffman-Goetz, PhD, MPH, of the University of Waterloo in Canada, wanted to know if text and photographic instructions were equally effective ways to prompt patients to check their own skin for  cancer. To test this, they culled through 5,330 peer-reviewed studies to find research projects that used photos as part of their educational materials on skin self-examinations. The results of their study (subscription required) appeared recently in the Journal of the American Academy of Dermatology.

The researchers found that patients who were shown images of skin cancer examined their skin more often, and were more adept at spotting suspicious-looking skin than patients who’d only read text descriptions of the how to check for skin cancer. Hoffman-Gotez explains why this might be, and the significance of the findings, in a university press release:

Visual images capture our attention and are persuasive. They also help us to learn and remember… Incorporating images into clinical practice when educating patients can be a powerful tool in the fight against skin cancer.

Holly MacCormick is a writing intern in the medical school’s Office of Communication & Public Affairs. She is a graduate student in ecology and evolutionary biology at University of California-Santa Cruz.

Previously: Working to protect athletes from sun dangersStanford clinic addresses cancer-related skin issuesAs summer heats up take steps to protect your skinMan’s story shows how cancer screenings saves livesNew research shows aspirin may cut melanoma riskNew skin cancer target identified by Stanford researchers and More evidence on the link between indoor tanning and cancers
Photo U.S. Department of Veteran’s Affairs

Dermatology, Public Health

Beat the heat – and protect your skin from the sun

With temperatures high across the country, Joyce Teng, MD, director of pediatric dermatology at Lucile Packard Children’s Hospital and a clinical associate professor at Stanford, has some reminders on how people can protect themselves against the sun. Her tips and some factoids – including the fact that 75,000 new cases of melanoma are expected in 2013 – are included in a release and the infographic (link to .pdf) below.

Previously: Working to protect athletes from sun dangers, As summer heats up take steps to protect your skin, Stanford study: Young men more likely to succumb to melanoma,
How ultraviolet radiation changes the protective functions of human skin and Working to prevent melanoma

infographic

Cancer, Dermatology, In the News, Sports, Stanford News

Working to protect athletes from sun dangers

Working to protect athletes from sun dangers

sunsport2SUNSPORT, Stanford’s new program to educate student-athletes about the dangers of sun exposure, was featured in the health section of today’s San Francisco Chronicle.

The piece (subscription required) tells the story of Stanford distance runner Erik Olson, who was diagnosed with melanoma last summer at age 20. Following successful treatment, Olson has adopted healthy sun-protection habits and is working with SUNSPORT to encourage other outdoor athletes, and fans, to do the same.

SUNSPORT, a collaboration of the Stanford Cancer Institute, the medical school’s Department of Dermatology, Stanford Athletics, and Stanford Hospital & Clinics, provides student-athletes with information about their heightened risks for sun-related skin damage and works with the teams’ coaches and athletic trainers to reinforce skin-protection practices on a daily basis.

“Outdoor athletes are an at-risk group for skin cancer, and SUNSPORT offers structured prevention strategies as well as research into skin protection behaviors,” Beverly Mitchell, MD, director of the Stanford Cancer Institute, told me.

Susan Swetter, MD, director of Stanford’s Pigmented Lesion & Melanoma Program, is quoted in the article. Swetter, who recently published research showing that young white men have a 55 percent higher risk of death from melanoma than their female counterparts, is one of SUNSPORT’s founders.

More information on the program is available at SUNSPORT’s website.

Michael Claeys is the senior communications manager for the Stanford Cancer Institute.

Previously: As summer heats up take steps to protect your skin, Stanford study: Young men more likely to succumb to melanoma, How ultraviolet radiation changes the protective functions of human skin, Image of the Week: Stanford SUNSPORT and Working to prevent melanoma

Cancer, Dermatology, Public Health, Stanford News

As summer heats up take steps to protect your skin

As summer heats up take steps to protect your skin

Many of us know that we should wear sunscreen on a daily basis, even when it’s cloudy outside, but when pressed for time we often run out of the house without slathering on any sun protection. Whether this common practice results in a sunburn or a mild tan, the sun exposure can lead to DNA damage to the skin cells that accumulates over time.

With the Fourth of July holiday approaching, vow to adopt healthier habits and apply sunscreen daily. As a recent Stanford Community Newsletter article explains, doing so will protect your skin from premature aging, painful sunburns and skin cancer:

Summer brings more intense sunshine and with it the need to pay special attention to the skin, especially among children and teens. Research shows that periods of severe sun exposure or sunburn—especially during childhood—increases the chances of developing skin cancer.

“When you get sporadic but intense ultraviolet radiation exposure, it causes an insult to skin cells’ DNA, which is believed to initiate the malignant changes that can lead to skin cancer, including melanoma,” said Susan Swetter, MD, a professor of dermatology at Stanford and director of the Stanford Pigmented Lesion and Melanoma Program. “Once those DNA mutations occur, your cells are more susceptible to damage from ultraviolet light. This damage accumulates over your lifetime.”

Ultraviolet (UV) radiation from the sun and artificial sources (i.e., tanning beds) is responsible for sunburn, accelerated aging of the skin (called photoaging) and skin cancer. Approximately 95 percent of UV radiation is composed of UVA-type rays, which are strong all day and all year long. The other 5 percent are UVB rays, which penetrate the skin less deeply but are 400 times more intense in the summer and at midday between 10 am and 4 pm. UVB rays play a key role in sunburn and skin cancer.

Previously: How ultraviolet radiation changes the protective functions of human skin, More evidence on the link between indoor tanning and cancers, Working to prevent melanoma and California cities score below 50th percentile on ‘sun-smart’ survey
Photo by bark

Cancer, Dermatology, In the News, Patient Care, Stanford News

Stanford clinic addresses cancer-related skin issues

Stanford clinic addresses cancer-related skin issues

Last September, the Stanford Cancer Center opened a new clinic to address the skin-related side effects of cancer and cancer treatment. Stanford dermatologist Bernice Kwong, MD, recognized this unmet need while seeing oncology patients during her recent dermatology residency. A story in today’s San Francisco Chronicle (subscription required) highlights the Supportive Dermato-Oncology Clinic and the emergence of this new subspecialty in dermatology. Kristen Brown writes:

Some patients see a skin issue as a side effect not serious enough to schedule yet another doctor’s appointment. The dermato-oncology clinic not only specializes in treating dermatological problems particular to cancer patients, it conveniently does so where they already are: the Cancer Center.

“Patients feel bad if they think about their skin, because it seems so trivial compared to cancer,” said Dr. Bernice Kwong, a clinical assistant of dermatology at Stanford who founded the clinic. “Even it is a pretty significant skin issue, the tendency is to say, ‘I can tough this out. It’s just skin.’ ”

A skin condition, though, can be a serious issue for cancer patients. Skin problems can be itching, painful or infected. They can also cause patients embarrassed by their appearance to feel self-conscious. “It can really decrease quality of life,” said Kwong.

Previously: Surviving is just half the battle: More on Stanford’s new survivorship clinic and Wellness after cancer: Stanford opens clinic to address survivors’ needs

Cancer, Dermatology, Men's Health, Research, Stanford News

Stanford study: Young men more likely to succumb to melanoma

Stanford study: Young men more likely to succumb to melanoma

Young white men with melanoma have a 55 percent higher risk of death from the disease than their female counterparts, suggesting biological sex differences may play a role in outcomes in this deadly cancer, a new Stanford study shows. Though other studies have found that older men tend to fare worse when it comes to melanoma – the most serious form of skin cancer – this is one of the first to compare survival between men and women in a younger population.

The study focused on adolescent and young adults between the ages of 15 and 39 years, who were diagnosed between 1989 and 2009. Among the more than 26,000 patients studied, 1,561 died of the disease. Though males accounted for fewer cases overall (40 percent), they accounted for 64 percent of the deaths. Susan Swetter, MD, a professor of dermatology and the study’s senior author, said:

Studies worldwide have demonstrated that women diagnosed with melanoma tend to fare better than men in terms of improved survival, and this has mostly been attributed to better screening practices and behaviors in women that result in thinner, more curable tumors, and/or more frequent physician visits in older individuals that result in earlier detection. Our study focused on survival differences between young men and women diagnosed with cutaneous (skin) melanoma, who constitute a generally healthy population compared to the older adults who have primarily been studied.

The researchers found that the young men were significantly more likely to die of melanoma than young women their age, even taking into account factors typically related to poor prognosis, such as the tumor’s thickness, its location, histologic subtype and whether or not it had spread to other parts of the body.

“Our results present further evidence that a biologic mechanism may contribute to the sex disparity in melanoma survival, particularly since adolescent and young adults see physicians less frequently and are less likely to have sex-related behavior differences in skin cancer screening practices than older individuals,” said Swetter, who directs the Stanford Pigmented Lesion and Melanoma Program.

The results follow a previous analysis in Europe in 2012 which found that women with melanoma have a 30 percent survival advantage compared to men, despite similar follow-up and treatment, she said. And a more recent study out of Europe showed that even women with advanced melanoma do better in terms of survival.

Christina Gamba, MD, who recently graduated from Stanford’s medical school, was the study’s first author. She told me, “We feel that our study in a largely healthy, young population adds further evidence that a biological mechanism may be at play. Several theories for the survival disparity include differences in sex hormones, vitamin D metabolism, and immune regulation, but further investigation is needed to explore these proposed mechanisms.”

The research appears online today in JAMA Dermatology.

Previously: New research shows aspirin may cut melanoma risk, New skin cancer target identified by Stanford researchers, How ultraviolet radiation changes the protective functions of human skin and Working to prevent melanoma

Dermatology, Research, Stanford News, Stem Cells

‘Pacemaker’ channels in hair stem cells offer clues to tissue regeneration, say Stanford researchers

'Pacemaker' channels in hair stem cells offer clues to tissue regeneration, say Stanford researchers

The growth of hair on your head (and elsewhere on your body, for that matter) is a tightly regulated and fascinating biological activity. Researchers are particularly interested in understanding how the stem cells in the hair follicles, which are called bulge cells, know how and when to cycle in and out of dormancy. Learning more about this process, they believe, may provide the insight necessary to harness the regenerative capacity of many types of stem cells for tissue repair and renewal.

This week, Stanford dermatologist Anthony Oro, MD, PhD, and colleagues published a study (subscription required) in Genes and Development of a mouse model they developed of a human condition called Timothy syndrome. Patients with Timothy syndrome are born bald and often take months or years to develop any hair. They also suffer from cardiac abnormalities and physical malformations and usually die at a tragically young age. But they have a very interesting genetic mutation. As Oro explained to me:

Stem cells exhibit the ability to cyclically regenerate organs, but what controls the timing of activation remains a puzzle. Timothy syndrome (TS) patients carry mutations in a calcium channel called Cav1.2 that controls the timing of the heartbeat. TS patients exhibit both cardiac arrhythmia and a significant delay in the activation of the hair cycle.

Oro and his colleagues, including Stanford postdoctoral scholar and the study’s first author Gozde Yucel, PhD, were puzzled as to why bulge cells, which (they showed in their study) don’t respond to or rely on the electrical and molecular pulses that drive cardiac cells, would even have a calcium channel. They used mouse genetics and pharmacology to investigate the abnormality in hair stem cell timing in the animals with a similar mutation. They found that, in the mice, the channel functions to control the levels of stem cell regulators responsible for tissue regeneration. According to Oro:

These surprising results demonstrate a wider function for pacemaker channels in tissue stem cells, and suggest the existence of channel ligands that have therapeutic applications in regenerative medicine.

Previously New skin cancer target identified by Stanford researchers, The secret life of hair follicles, revealed by Stanford researchers and Examining the role of genetics in hair loss

Cancer, Dermatology, Videos

Man’s story shows how cancer screenings saves lives

Man's story shows how cancer screenings saves lives

Summer is almost here, and we’ve all heard how important it is to wear hats and sunscreen to protect our skin from the sun’s harmful rays – but few of us follow a regular regiment. Such was the case for David Duckworth, who watched his wife take sun protection seriously for years, but never thought he needed to, despite having fair skin.

When David’s employer offered a free skin cancer screening with Stanford dermatologists, he decided to take up the offer and get the freckles and dark spots on his face and arms checked out. The screening may very well have saved David’s life, as it caught a spot on his left collarbone that he hadn’t thought was abnormal. David’s diagnosis of basal cell carcinoma (the country’s most common form of cancer) has changed his every day behavior and made him an advocate of proper sun protection.

David’s story is captured in the Stanford Hospital video above. And local readers may be interested to know there’s a free skin cancer screening at the Stanford Medicine Outpatient Center this Saturday.

Previously: How ultraviolet radiation changes the protective functions of human skin, More evidence on the link between indoor tanning and cancers, Studies show new drug may treat and prevent basal cell carcinoma, Intense, rapid sun tanning may increase skin cancer risk and California cities score below 50th percentile on ‘sun-smart’ survey

Dermatology, Research, Stanford News, Stem Cells

The secret life of hair follicles, revealed by Stanford researchers

The secret life of hair follicles, revealed by Stanford researchers

Really. Come on. Who isn’t interested in hair? Hair growth, hair loss, hair thickness, hair shape, hair location. I’d bet that everyone of us spends at least a minute or two each day thinking about (or, if you’re like me, futilely plucking and prodding at) the state of our locks.

Now Stanford researchers have delved deep into the cells surrounding our hair follicles to better understand what makes them grow and maintain hair. Perhaps not surprisingly, the answer lies in the stem cells (here, called ‘bulge cells’) within the follicle.

Specifically, research associate Yiqin Xiong, PhD, and associate professor of medicine Ching-Pin Chang, MD, PhD, have identified a signaling circuit that controls the cells’ activity. The research was published yesterday in Developmental Cell (subscription required). As Chang explained in an e-mail to me:

By promoting self-renewal of stem cells, this circuit maintains a healthy pool of bulge cells for repeated cycles of hair growth and regeneration. Each cycle of hair regeneration is initiated by the activation of this circuit in those bulge cells, and subsequent growth of the hair is sustained by the circuit in hair matrix cells.  Besides hair regeneration, the circuit is triggered by skin injury to stimulate migration of the bulge cells to the wounded area to differentiate into epidermal cells, thereby regenerating epidermis over the wounded skin.

In the past, news about hair growth (and how to stimulate it) has been a trigger for a deluge of interest from media and individuals struggling with… (how shall we say it?) ‘hair problems.’ But the research has many implications beyond hair, or the lack thereof. For example, the presence or absence of hair follicles on the skin affect how the skin heals after a wound, and whether a scar remains. According to Chang:

This molecular circuit in the hair follicle can be targeted for therapeutic purposes. Because of its activity in hair regeneration, inhibition of this circuit can reduce hair growth in patients with excessive hairiness (hirsutism), whereas activation of this pathway can promote hair growth for people with baldness (alopecia). Also, for its activity during epidermal regeneration, activation of the circuit can facilitate wound healing for patients receiving surgery and for diabetic patients who have wounds that are difficult to treat. The activity of the circuit in both hair follicle and epidermal regeneration may have additional therapeutic benefit. Lack of hair follicles in a wounded area is a hallmark of scar formation. Targeting this pathway has the advantage of promoting both hair follicle formation and wound repair, thus reducing scar formation in the wound.

Interestingly, one of the key molecules, called Brg1, involved in this regulatory circuit has also been implicated in previous work from Chang’s lab in the enlargement of the heart and in fetal heart development. It’s apparent this story has many layers, some more than skin deep.

Previously:  Examining the role of genetics in hair loss and Epigenetics: the hoops genes jump through,
Photo by Furryscaly

Cancer, Dermatology, NIH, Podcasts, Research, Stanford News, Women's Health

New findings on aspirin and melanoma: Another outcome of the Women’s Health Initiative

New findings on aspirin and melanoma: Another outcome of the Women's Health Initiative

There has been a lot of interest in the Stanford study suggesting that aspirin reduces the risk of melanoma in women; dermatologist Jean Tang, MD, PhD, spent much of her day today discussing the findings with reporters from NPR and the three networks’ evening news programs. Earlier, in a 1:2:1 podcast, Tang talked about her work and described the importance of the Women’s Health Initiative (WHI), from which she and her co-investigators pulled their data:

The Women’s Health Initiative was funded by the National Institutes of Health and American taxpayers’ dollars…  This was a huge investment of taxpayers’ dollars, and it has incredibly paid off, [producing] many published papers and, more importantly, many important messages and conclusions about the health of American women.

Women were enrolled [in the WHI] to reflect the multi-ethnic population of the U.S. So American Indians are represented, Mexican-American women are represented, black women are represented. You are never going to get the richness and diversity of the women represented in this database anywhere else in the world.

Previously: New research shows aspirin may cut melanoma risk

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