How I Became Involved in Dermatologic Ultrasound

There are certain moments in time when your gut tells you that your life is about to change. It happened to me in 1999.

I was on a training visit to the Musculoskeletal Ultrasound Section of the Department of Diagnostic Radiology at the Henry Ford Hospital in Detroit when Dr WortsmanI saw a “hockey stick” probe. Instinctively, I decided to use it on my fingernails. The images I saw on the screen were so fantastic that I ran to the library to see if there were any papers or publications that focused on ultrasound of the nail.

Surprisingly, I discovered a few Italian and Danish dermatologists who were working with smaller types of high frequency ultrasound devices on experimental settings. Wanting to learn more, I wrote to them. I was thrilled when Professor Gregor Jemec responded and agreed to collaborate.

However, getting an ultrasound machine for a dermatology project proved to be more difficult. It took almost 2 years before an ultrasound machine was installed and available for me to use while I was at the Department of Dermatology at Bispejerg Hospital in Copenhagen.

After securing the machine, I had the opportunity to scan dermatologic patients on a daily basis and I realized the great potential this imaging modality had within dermatology.

Once I returned to Chile, I really got to work. I studied the sonographic patterns, began to correlate the ultrasound images with the clinical and histologic findings, and started to publish the results.

That also proved difficult at first because radiology journals felt the content was better suited for dermatology journals and dermatology journals recommended radiology journals since the content involved imaging. Probably these journals had a difficult time even finding someone to review this material.

It was during this rough beginning that I reached out to my uncle Jacobo. I was telling him how difficult publishing could be and he simply reiterated President Truman’s famous quote, “If you can’t take the heat, get out of the kitchen.”

That just made me more committed. I created an educational website and continued to practice, learn, research, and write. In 2010, the Journal of the American Academy of Dermatology published our paper that analyzed more than 4,000 dermatologic ultrasound cases with histologic correlation. In 2013, our book Dermatologic Ultrasound with Clinical and Histologic Correlations was published.

Since that time, a lot has changed. I used to hear radiologists and dermatologists comment that they had never heard of dermatologic ultrasound. Now, the use of ultrasound in dermatology is expanding rapidly with colleagues from around the world using this tool to diagnose common dermatologic conditions earlier and more precisely.

For me, the dermatologic ultrasound journey mirrored my family’s immigration journey. We both left something familiar and ended up in a distant land. While the journey has not been easy, the results have been more than worthwhile.

But our work continues. Now, one of our challenges is how to share what we have learned to inspire and train a new generation of dermatologic ultrasound professionals. As a specialty, we are excited by AIUM’s support through the development of a dermatologic ultrasound interest group. Here we will share information, research, and resources. Please join us!

Why did you becoming interested in ultrasound? Have you participated in your AIUM Community? What struggles have you overcome in your career? Comment below or let us know on Twitter: @AIUM_Ultrasound.

Ximena Wortsman, MD, Radiologist, Chair of Dermatologic Ultrasound AIUM Interest Group, Senior Member of AIUM, Department of Radiology and Department of Dermatology, Institute for Diagnostic Imaging and Research of the Skin and Soft Tissues, Clinica Servet, Faculty of Medicine, University of Chile, Santiago, Chile.

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