Belaray Dermatology - Jericho, Plainview, Long Island, NY

Izzie, from Grey’s Anatomy, was diagnosed with stage 4 melanoma in season five.

Melanoma is the most serious type of skin cancer, that is most common in fair skinned individuals.  In sun prone areas, like New Zealand, about one in fifteen Caucasians will be diagnosed with one.  Most melanoma is diagnosed after age 40, with only about 14% of cases diagnosed in younger individuals. In the US, about 55,000 cases are diagnosed per year, and on average one person dies every hour from this cancer.

Melanoma, when diagnosed early, is almost always treatable.  When diagnosed late, the prognosis is often poor, and effective treatment options limited.

What should you do?

1. Protect yourself from the sun using hats, seeking shade, and avoiding peak hours of the day (from 10am-4pm)

2. Learn what the signs of a problem are - when you examine your moles and freckles

2. Make an appointment with your dermatologist for a full body skin examination - and bring your family

Here is information about clinical trials in NY for treating Melanoma

Smile at the world… and the world will smile back.

According to a study published the March issue of the Journal of Cosmetic Dermatology, Botox may lift patients’ “spirits” by “literally wiping the frowns” off their faces.  It has been long known that our facial expressions can influence our mood - and simply smiling can make you feel better.  Not surprisingly, it seems that Botox can have the same beneficial effects.

Research suggests that Caffeine kills some skin cancer cells.  According to a study published in the Journal of Investigative Dermatology this month,  “caffeine could be added to sunscreen to boost protection against the most common form of skin cancer.”  We do not find this surprising.  Infact, we have thought that for a long time.  That is why we offer our patients a sunscreen that has Caffeine as well as potent antioxidants from green tea.  We believe that the best protection you can get is by combining sunscreen, caffeine, and anteoxidants - and that is just what we do in our Anteox Sunscreen.

BBC News reports, “An unlicensed medicine which can be injected to produce a tan may be responsible for worrying changes in skin moles, say doctors. Two women told Salford dermatologists that they had both injected ‘Melanotan’ shortly before noticing the problem.” One woman “had two moles on her foot which had increased in size and darkened over just a few weeks. The other, who was 30, told doctors that the moles on her back had also rapidly darkened.” Medical watchdog groups “have issued warnings about the untested nature of the Internet-supplied jabs, the British Medical Journal reports.

We do not recommend to our patients the use of this product.

Scientists have discovered the earlier the vaccine is used, the better. Skin cancer can
take years to develop and the jab works best if given before cells begin to mutate within the skin.

It raises the possibility that the vaccine, which has a better safety record than many
others, could be used in childhood to protect against the disease later in life, providing
further studies support the latest findings.

Malignant melanoma kills around 1,700 people a year and is the third most common
cancer in people aged 15 to 39. Over-exposure to the sun’s rays is the biggest cause and since the mid-1990s there has been a 24 per cent increase in cases in the UK.

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Bloomberg News (11/16, Scott) reported that a “vaccine to prevent skin cancer may be ready for children within five to 10 years.” In fact, the “Australian scientist who created vaccinations for cervical cancer” has tested such a vaccine on animals.

According to Gardasil developer Prof. Ian Frazer, “it was not yet known how many skin cancers were caused by the” human papillomavirus, “a common infection which can turn abnormal cells into cancer,” AFP (11/16) added. Yet, the “new vaccine would target” human papillomavirus, and it “would be used on children aged between 10 and 12 to prevent them from developing skin cancer,” according to Frazer, who is expected to deliver “his findings to the Australian Health and Medical Research Congress on Monday.”

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Experimental Drug Ustekinumab Trumps Enbrel in 3-Month Trial; Longer-Term Results Unknown

An experimental drug called ustekinumab shows better treatment results than an established drug, Enbrel, for treating moderate to severe plaque psoriasis in a new trial.

In a news release, the drug company Centocor, which makes ustekinumab and sponsored the study, calls the new drug “superior” to Enbrel.

But Amgen, the drug company that makes Enbrel, notes that the study only lasted for 12 weeks and didn’t address long-term safety.

Both ustekinumab and Enbrel are biologic drugs. Ustekinumab targets two inflammatory chemicals, interleukin 12 and interleukin 23. Enbrel is a TNF blocker; that is, it inhibits tumor necrosis factor (TNF).

In the new study, 903 patients with moderate to severe plaque psoriasis either got ustekinumab (in a higher or lower dose) or Enbrel for 12 weeks.

Patients in the ustekinumab groups got one shot of the experimental drug in their assigned dose when the study started and another shot four weeks later. Patients in the Enbrel group got two shots of Enbrel every week for 12 weeks.

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So reads the headline published in the LONDON (Reuters) in an article by Michael Kahn, discussing a publication by Johan Moan in PNAS, titled “Addressing the health benefits and risks, involving vitamin D or skin cancer, of increased sun exposure” Abstract Free Full Text

This is an eye catching headline, and thought provoking paper - but both are somewhat misleading. In this paper, Johan Moan and colleagues have suggested a slight relationship between the prognosis of some cancers and latitude. That is to say, for some times of cancer, you might be expected to live a little longer if you reside closer to the equator.

The researchers take this discovery and run with ideas and possible explanations. They suggest that patients closer to the equator get more sun, and the sun is responsible for making Vitamin D in the skin. They further suggest that low levels of Vitamin D may put you at risk for not doing as well with some types of cancer.

What is notable here are several things that the researchers have not demonstrated. For example, the researchers have not shown that there is a difference in the level of Vitamin D at different latitudes. Certainly one would expect that if exposed to more sunlight, an individual will produce more Vitamin D. However, Vitamin D also is introduced into our body by the things we eat. Vitamin D is readily supplemented in milk, yogurt, margarine, oil spreads, breakfast cereal, pastries, and bread. It is naturally found in fish, fish oils, mushrooms, and eggs. Several previous studies have looked at Vitamin D levels in different countries, and it is not generally believed by scientists that there is any difference in Vitamin D levels at different latitudes.

Of note, the researchers also present data in their paper that suggests that there is a higher likelihood of developing colon, lung, prostate, and of course melanoma in patients living closer to the equator. This finding was not made much mention of in either the original article, nor the newspaper coverage.

In summary, Vitamin D is an interesting compound that we need to learn more about… but this paper falls far short of the headline it was given “More sun is healthy.” For now, we suggest you stick to your sunblock and hats!

Researchers in Canada looked at 153 YouTube videos about vaccination and immunization. They found that over half of the videos published childhood, flu and HPV vaccines in a negative or ambiguous light. Forty-five of them contradict recommendations contained in the Canadian Immunization Guide (2006).  Videos that portray vaccinations in a negative light receive significantly more traffic than those that portray them in a positive light

Since YouTube is increasingly a resource people consult for health information, it is concerning that a significant amount of immunization content contradicts the nation’s reference standard.

On a review of dermatology related YouTube videos, we have found the helpful mixed with the bizarre.  What we also found surprising was the amount of dermatology related YouTube videos that were an advertisement.  For example, we refer you to an earlier blog where we suggest you visit this YouTube video that teaches you how to do a self skin examination.  What we did not mention is that we were surprised how difficult it was to find a video that we thought was helpful on the topic.  We spent our time screening YouTube to bring you content that we thought was worthy of your time.  But isn’t that what doctors are supposed to do?

YouTube is simply a venue for information… as is the radio, newspaper, magazine, and TV.  It is a venue that allows syndication of the people… and is filled with helpful, as well as silly, commercialized, bogus, exaggerated, biased, and simply incorrect content – mirroring every branch of the media.  I doubt that the ‘anti-vaccination’ YouTube popularity will result  in a public health crisis.  It is likely a curiosity amongst viewers, and it is being viewed because it is a different viewpoint than you will get when you visit your physician. 

What would we like to see?  Dermatology residency programs should consider taking the initiative to fill YouTube with helpful content that patients and colleagues will find enjoyable to watch.  And while they are at it… they should make it their responsibility to correct, update, and monitor other public sources like wikipedia.  As respectable organizations begin to take the lead in bringing trustworthy, reliable, informative, and interesting content to viewers, we will all be better off.

“YouTube as a Source of Information on Immunization: A Content Analysis”
Jennifer Keelan, PhD, Vera Pavri-Garcia, PhD, George Tomlinson, PhD, Kumanan Wilson, MSc, MD
JAMA Vol. 298 No. 21, December 5, 2007

We wanted to share with you an important study from the American Journal of Medicine: “ Smoking cessation may be a potentially important target for the prevention and management of psoriasis.”

In this study, researchers have shown that current, past, as well as cumulative levels of smoking, are associated with an increased risk of psoriasis.  And the more you smoke…. the higher your risk.  Prenatal exposure, and second hand smoke also put you at risk.  They have also shown that the risk decreases to nearly baseline levels after 20 years of abstinence. 

This adds one more important reason to consider quiting.  We know that quitting can be very difficult, and if you feel ready to quit you should speak with your internist for help.  There are many tools available to help you break this addictive habit.