Melanin Content in the Hair: an Early Prediction of Melanoma Risk

Melanin Content in the Hair: an Early Prediction of Melanoma Risk

Overexposure to ultraviolet (UV) radiation from the sun and artificial UV radiation sources is of considerable public health concern. It plays a major role in the development of skin cancer and eye damage. There is increasing evidence that it suppresses the immune system, which could lead to a reduction in the efficacy of immunization programmes and increase the spread of infectious diseases.

Melanoma is a type of skin cancer. It begins in skin cells called melanocytes (say: “mel-an-oh-sites”). Melanocytes produce the substance that gives your skin its color.Most other skin cancers don’t spread, but melanoma can spread through the whole body. If it is found early, it can be cured. If it is found late, it may cause death.

Melanoma is the most serious and deadly type of skin cancer. Melanoma develops in the cells that produce melanin — the pigment that gives your skin its color. Melanoma can also form in the eyes and, rarely, in internal organs, such as the intestines.The exact cause of all melanomas isn't clear, but exposure to ultraviolet (UV) radiation from sunlight or tanning lamps and beds greatly increases the risk of developing melanoma.

Melanocytes are normally located throughout the skin and produce melan pigment. Melan pigment is produced by these cells when exposed to sunlight as part of the tanning process. Regular moles contain groups of melanocytes. Melanoma begins when an individual melanocyte loses its ability to regulate its own growth, like a copy machine with a broken counting mechanism that continues to make copies even when you keep pushing the stop button. With time the melanoma grows. The earlier you find it and the thinner it is, the better the chance of complete cure.

Sun exposure during childhood and adolescence increases the risk of both melanoma and non-melanoma skin cancers in later life.A significant part of a person’s lifetime UV radiation exposure occurs before age 18 and children have more time to develop diseases with long latency, and more years of life could be lost and more suffering endured as a result of impaired health.

The risk of death from cutaneous melanoma is determined mainly by the thickness of the tumor, as described by Breslow,1 the presence or absence of tumor ulceration and microdeposits of melanoma in sentinel lymph nodes,2,3 the site of the tumor, and the patient's sex.4 Spread occurs by lymphatic and hematogenous routes. Micrometastases from primary tumors migrate through cutaneous lymphatics to the regional lymph nodes. Traditionally, wide margins of excision have been used to prevent lymphatic spread, but over the past decade, margins have become smaller because previous trials have suggested that narrower margins are safe.5,6,7 The issue remains controversial because inadequate excision margins increase the risk of local recurrence and in-transit metastases, both of which are associated with a high mortality rate.8 Conversely, unnecessarily large margins of excision are associated with greater morbidity and increased cost.

Melanoma may appear on normal skin, or it may begin at a mole or other area that has changed in appearance. Some moles present at birth may develop into melanomas.The development of melanoma is related to sun exposure, particularly to sunburns during childhood, and is most common among people with fair skin, blue or green eyes, and red or blond hair.It is the leading cause of death from skin disease.

Between two and three million non-melanoma skin cancers are diagnosed worldwide each year, but they are rarely fatal and can be surgically removed. Approximately 130,000 malignant melanomas occur globally each year, substantially contributing to
mortality rates in fair-skinned populations.An estimated 66,000 deaths occur annually from melanoma and other skin cancers.

The most common types of Melanoma in the skin:

Any of the above types may produce melanin (and be dark in colour) or not (and be amelanotic - not dark). Similarly any subtype may show desmoplasia (dense fibrous reaction with neurotropism) which is a marker of aggressive behaviour and a tendency to local recurrence.

Study suggest that, in a small number of patients, the melanoma cells that remain after excision with a 1-cm margin will prove fatal. We therefore recommend that the use of a 1-cm margin should be avoided in patients with melanomas that are at least 2 mm thick.

Measuring the amount of melanin in a hair sample independently predicts an individual's risk for melanoma, according to a report in the issue of the American Journal of Epidemiology.

Melanin is a natural substance that gives color to the hair, skin and iris of the eye, and also protects the skin from damaging rays of the sun.

Determining the amount of melanin as an indication of an individual's skin type could be used to advise patients how often they should be screened for skin cancer and to also provide individualized patient advice, Dr. Stefano Rosso told Reuters Health.

Rosso from the Piedmont Cancer Registry, Turin, Italy and associates note that hair concentrations of melanin can be measured by various means.

They used different methods to determine the melanin content in the hair of study participants in Europe and South American (2001-2002) who were enrolled in a large, multicenter skin cancer trial. The study included 98 subjects with melanoma, who were matched with a comparison group of 98 without melanoma.

The researchers found that measuring 2,3,5-pyrroletricarboxylic acid (PTCA) levels, which forms after the oxidation of the pigment eumelanin, provided the strongest results.

After accounting for the effects of hair color, eye color and number of moles, the researchers found that the subjects with a PTCA concentration below 85 ng/mg had more than four times the risk of developing melanoma, the team reports.

Near infrared spectroscopy, which the researchers describe as "a less precise but faster and cheaper type of measurement of eumelanin," was associated with a two-fold increased risk of melanoma, but this was not statistically significant after controlling for other risk factors.

Nevertheless, Rosso said, his group wants to develop near infrared spectroscopy further, so that it may be used to use directly measure melatonin.

The investigators point out that determination of the PTCA also provides the chance to study the role of melanin in the direct causes of skin tumors.

"We plan to further extend melanin measurement to squamous-cell carcinoma and basal-cell carcinoma in the same case-control setting," Rosso added.


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