Orlando Dermatologist Michael Steppie, MD, Investigates Vitiligo
Teaming up with medical research institution Sanford Burnham Prebys, Dr. Steppie studied the causes of vitiligo in hopes of finding a cure.
Dr. Steppie, president and medical director of Associates in Dermatology, is also a dedicated researcher and healthcare advocate. In studying vitiligo, he and his colleagues are learning more a condition that challenges patients and physicians alike.
“The promise of a treatment that cures vitiligo — rather than just dealing with symptoms alone — is particularly exciting,” said Dr. Steppie, who is also a clinical professor of dermatology at Florida State University College of Medicine.
What Is Vitiligo?
In vitiligo, patches of skin across the body turn white for no apparent cause. Vitiligo can also affect mucous membranes inside the mouth and nose, and even the eyeball. If there’s hair on the affected skin, the hair turns white, too. In some cases, vitiligo can spread from the original patches and cover much of the body.
Between 0.5 and 1 percent of people get vitiligo, which typically appears in early adulthood, though it can affect people of any age. It’s most noticeable in people with dark complexions. Vitiligo can affect people of any race, men and women alike, and it tends to run in families.
Vitiligo does not cause illness; however, the white patches are highly susceptible to sunburn and should be covered or protected with sunscreen. And many people find the disease psychologically unpleasant and damaging to their confidence and self-esteem. Severe cases can be life-altering for those who suffer from them.
There’s no cure for vitiligo, but doctors can offer treatments to reduce the discoloration, including corticosteroids, light therapy and photochemotherapy with psoralen, a skin-darkening drug. Sometimes, patients may opt for treatments to lighten the unaffected skin to achieve a more even skin tone.
Conquering the Condition
Vitiligo is caused by the destruction of melanocytes, or skill cells that produce pigment. However, researchers don’t yet know why the melanocytes are destroyed. That’s the puzzle Dr. Steppie and his colleagues, including Ranjan J. Perera, PhD, scientific director of analytical genomics and bioinformatics at Sanford Burnham Prebys, were trying to solve.
While scientists have long associated vitiligo with autoimmune disease, Drs. Steppie and Perera and their colleagues suspected another culprit. Vitiligo cells do not contain the microRNA known as miR-211, a form of microRNA involved with regulating gene expression. Messenger RNA such as miR-211, the researchers believe, may turn off several genes linked to mitochondria creation. Mitochondria produce the energy cells need to do their work. In terms of vitiligo, this means that a cause may have been found for the disease: without miR-211, some skin cell mitochondria are deficient, and the result is the cells don’t produce pigmentation.
Drs. Steppie and Perera are now planning large-scale studies to validate these findings. When they completely understand the biological pathways responsible for vitiligo, they hope to identify a way to cure the condition — or prevent it in the first place.
The study was published in the Journal of Investigative Dermatology in May 2017.
Do you have a concern about vitiligo or another skin condition? The physicians at Associates in Dermatology can help. Call 800-827-SKIN for an appointment.