UM Brings Top Dermatologist To Lead Melanoma Clinic

Main Category: Dermatology
Article Date: 13 Jan 2009 - 3:00 PST

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James M. Grichnik, M.D., Ph.D. has joined the University of Miami Miller School of Medicine as professor of dermatology and cutaneous surgery. Grichnik, who earned his medical degree from Harvard University, will focus his attention on expanding the melanoma program at the Sylvester Comprehensive Cancer Center.

An expert in early detection, Grichnik says one of the program's goals is to develop the Melanoma Surveillance and Detection Clinic, a world class facility that will utilize imaging technologies such as dermoscopy, confocal microscopy, and total body photography to allow for melanoma detection at early, more curable, stages. He comes to UM following 17 years at Duke University, where he focused much of his research on cell biology and the role of stem cells in the development of melanoma.

"I am especially interested in the tumor biology of melanoma," says Grichnik. Melanoma is the deadliest form of skin cancer that scientists generally believe begins in the pigment cells of the skin called melanocytes. Melanocytes produce melanin, which gives skin its natural pigment or color. Benign clusters of melanocytes are called moles (or nevi), malignant clusters of melanocytes are melanoma.

Grichnik, however, believes that melanomas and moles originate from melanocytic stem cells in the skin and not from differentiated melanocytes. These melanocytic stem cells normally function to make more pigment cells. He believes if these cells harbor a benign mutation they form a benign mole but if they harbor malignant mutations they form melanoma. "Within the melanoma tumors a subset of cells with stem-cell-like features persist," he explains and "until we develop therapies that also eliminate this population we will not be able to fully eradicate the tumor." Grichnik's research efforts are focused on pathways expressed in the melanoma stem cells that may serve both to specifically identify malignant tumors and as targets for therapy.

Patients are at an increased risk for melanoma if they have a personal or family history of melanoma, a high number of moles, or atypical moles. Those with fair skin, red or blond hair, and lighter eyes also are at an increased risk for melanoma. The most important part of melanoma care is early detection and surgical removal, but that approach does not prevent a systemic recurrence once the melanomas are more advanced and tumor cells have already entered the circulation. Some of Grichnik's goals are to implement practices that improve survival rates through early detection while at the same time avoiding unnecessary biopsies and procedures. "Once we better understand melanoma biology, we will be able to develop better more curative therapies."

The Melanoma Surveillance and Detection Clinic will have ongoing clinical trials, and use a number of methods to detect early melanomas and other skin cancers as well as studying normal skin biology. "We are building a structure to facilitate basic research and an increasing capacity to deliver world class melanoma clinical care," says Grichnik.

University of Miami Miller School of Medicine