As temperatures rise and more time is spent outdoors, dermatologists urge everyone to pay closer attention to their skin. According to the American Cancer Society, melanoma — the deadliest form of skin cancer — is expected to be diagnosed in more than 112,000 Americans this year as invasive disease, a figure that has climbed nearly 47% in the past decade. When caught early, melanoma is among the most treatable cancers, with a five-year survival rate around 99% for localized disease. 

A vast majority of melanoma cases are linked to ultraviolet exposure from sunlight, making it largely preventable. Risk factors include fair skin, a history of sunburns (especially in childhood), numerous moles, and a family history of melanoma. But melanoma does not discriminate; it can develop in people of all skin tones and in areas that rarely see the sun. 

Dermatologists recommend the ABCDE rule as a guide for self-examination: 

• Look for Asymmetry (one half of a mole doesn’t match the other),
• irregular Borders,
• uneven Color,
• a Diameter larger than a pencil eraser, and
• an Evolving shape, size or color.

Any spot that looks different from the moles around it — the so-called ugly duckling — also warrants professional evaluation. The most important step you can take is scheduling a routine skin check with a board-certified dermatologist. 

“Early detection saves lives, and it starts with knowing your own skin,” says Allison Hanlon, MD, PhD, Professor and Chair of the Department of Dermatology at Vanderbilt Health. “When melanoma or another skin cancer is found early, our Mohs surgery team can often remove it completely in a single outpatient visit while preserving as much healthy tissue as possible.” 

Mohs micrographic surgery is widely considered the gold standard for treating many skin cancers. Unlike standard excision, the Mohs technique examines 100% of the tissue margin under a microscope, layer by layer, until no cancer cells remain. The result is a cure rate of up to 99% for new skin cancers and the smallest possible wound, which is especially important for tumors on the face, ears, hands, and other cosmetically or functionally sensitive areas. 

Vanderbilt Health’s Mohs Micrographic Surgery program brings together a fellowship-trained team of four Mohs surgeons: Hanlon; Anna Clayton, MD, Associate Professor of Dermatology and Director of the Micrographic Surgery and Dermatologic Oncology Fellowship; Stacy McMurray, MD, Assistant Professor of Dermatology and Associate Program Director for the Mohs Fellowship; and Emily Merkel, MD, Assistant Professor of Dermatology. The team collaborates with surgical and medical oncology specialists to develop individualized plans for even the most complex cases. 

Mohs surgery at Vanderbilt Health is performed at Vanderbilt Dermatology, located at Vanderbilt Health One Hundred Oaks, 719 Thompson Lane in Nashville. 

To schedule a skin cancer screening or learn more about Mohs surgery services, call 615-322-6485 or visit the Vanderbilt Health Dermatology website. 

The post Protect your skin: What to know about melanoma and Mohs surgery at Vanderbilt Health  appeared first on Vanderbilt Health News.

The dietary supplement nicotinamide has been recommended by dermatologists for people with a history of skin cancer since 2015, when a clinical study with 386 participants showed that those who took the vitamin B3 derivative developed fewer new occurrences. 

However, data to validate those findings in a larger study group has been lacking because nicotinamide can be purchased over the counter without being entered into patients’ medical records.

In a new study published Sept. 17 in JAMA Dermatology, researchers found a way to get that data by analyzing records from the Veterans Affairs Corporate Data Warehouse. Nicotinamide is on the VA’s official formulary, so the researchers checked the outcomes of 33,833 patients for their next skin cancer diagnosis following baseline treatment with 500 milligrams of nicotinamide twice daily for longer than 30 days. They looked for occurrences of basal cell carcinoma and cutaneous squamous cell carcinoma. 

The researchers compared 12,287 patients who received the treatment with 21,479 who did not. Overall, there was a 14% reduction in skin cancer risk. When nicotinamide was taken after a first skin cancer, the risk reduction rose to 54%, but the benefit declined with treatment initiation following subsequent skin cancers. The risk reduction was much larger for squamous cell carcinoma.  

“There are no guidelines for when to start treatment with nicotinamide for skin cancer prevention in the general population. These results would really shift our practice from starting it once patients have developed numerous skin cancers to starting it earlier. We still need to do a better job of identifying who will actually benefit, as roughly only half of patients will develop multiple skin cancers,” said the study’s corresponding author, Lee Wheless, MD, PhD, assistant professor of Dermatology and Medicine at Vanderbilt University Medical Center and a staff physician at VA Tennessee Valley Healthcare System. 

The researchers were also able to ascertain the outcomes of 1,334 patients who were immunocompromised due to having received solid organ transplants. Among solid organ transplant recipients, no overall significant risk reduction was observed, although early nicotinamide use was associated with reduced occurrences of cutaneous squamous cell carcinoma. 

Wheless received research support from a Department of Veterans Affairs grant (IK2CX002452). Other Vanderbilt authors on the study are Katyln Knox, Rachel Weiss, Siwei Zhang, PhD, Lydia Yao, MS, Yaomin Xu, PhD, and Kyle Maas. 

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