"The Scan" is the offcial blog of the American Institute of Ultrasound in Medicine (AIUM). On December, 1, 2015 the article " How I Become Involved in Dermatologic Ultrasound" was published. This article is about how Dr. Wortsman began in the dermatologic ultrasound field.
It is a great honor to be part of this prestigious and well-known blog among the North American sonographers.
More info at: Derm Ultrasound AIUM
"The Scan" es el blog oficial del Instituto Americano de Ultrasonido en Medicina (AIUM). El 1 de Diciembre del 2015 se publicó el artículo llamado " How I Become Involved in Dermatologic Ultrasound" . Este articulo cuenta como la Dra Wortsman comenzó su trabajo en el campo de ultrasonido dermatologico.
Es un gran honor ser parte de este prestigioso y muy conocido blog entre los sonografistas norteamericanos.
Mas informacion en: Derm Ultrasound AIUM
Article published in "Caras" Magazine
September, 12, 2014
Technology in Skin Cancer
Early and Exhaustive Detection
In Chile 10 of every 100 thousand people suffer from skin cancer. Faced with this reality, there is now a technology – a world first – to detect what lies underneath the lesion that doctors cannot see with the naked eye.
Various studies have shown that by 18, most Chileans have absorbed 80% of the solar radiation that they will receive over their whole lifetime. The thinning of the ozone layer and lack of awareness of the dangers of ultraviolet rays have caused skin cancer to increase over the years.
Skin cancer is the uncontrolled growth of anomalous cells. It arises from damage to the DNA of cells of the dermis, principally caused by ultraviolet radiation from the sun or solarium. This damage causes mutations or genetic defects, unleashing rapid multiplication of skin cells and leading to malignant tumors.
Dr. Ximena Wortsman, Director of the Institute for Diagnostic Imaging and Research of the Skin and Soft Tissues (IDIEP) is a radiologist by profession. Over the past 12 years she has developed the use of ultrasound to gain information hidden in the depth of the lesions in the skin, which is not possible to obtain by a doctor's visual inspection or by biopsy.
The technique is named Color Doppler Ultrasound, as used in pregnancy but used by Dr. Wortsman only for dermatological purposes, using special equipment for the skin, nails and hair. This new application for the tool represents a contribution that has caused a revolution in dermatology, by showing the internal details of what we have always seen only externally.
“It's like taking a photo or video inside” the doctor explains. She adds that this examination allows us to know the exact depth of a benign or malignant skin tumor, and if it compromises another organ.
The patients who come to the IDIEP Center have all been referred there by other doctors: dermatologists, plastic surgeons, oncologists or internal medicine specialists, among others. “The majority of them arrive with a diagnosis already made, but using this examination we can go further”. “There are people who have arrived with a small lesion which turned out to be a tumor several centimeters deep, with a high degree of vascularization compromising deeper tissues such as cartilage, muscle or bone”. These data are important to know before planning the treatment, and can be extremely significant if occurring in a very visible place such as the face.
Benefits of Color Doppler Ultrasound
Thanks to this information, the treating doctor can:
-Properly plan the treatment according to the real situation of each patient.
-Decrease the probability of future recurrence.
-Reduce the possibility of multiple biopsies and/or scarring.
-Help the complete elimination of the tumor, by knowing its size, location, vascularization and real depth.
This imaging technique, furthermore, serves to detect and monitor other lesions of the skin such as vascular anomalies (hemangiomas or malformations) and inflammatory diseases (psoriasis, morphea (cutaneous scleroderma), among many others).
In the cosmetics area it allows diagnostic support for complications, as for example ultrasound identifies and quantifies the type of cosmetic filler injected, which in many cases is not what the patient believes. In many cases, instead of Hyaluronic acid, silicone oil or another filler is injected.
Nails and Hair
This kind of ultrasound study also allows the observation of the nail to diagnose hidden tumors. Another application is the study of the scalp, analyzing the hair follicles in the dermis and some tumors or cysts which also, in some cases, produce hair loss.
The IDIEP Center is a world pioneer in this imaging technique, which can be carried out in patients of any age, with no radiation danger and no pain.
Source: 'Corporación Nacional del Cáncer, Conac' (National Cancer Corporation).
Interview to Dr. Ximena Wortsman
RADLA 2014 Congress
May 4, 2014
The International congress RADLA Santiago took place on May 2-5, 2014, and gathered more that 2,300 dermatologists from LatinoAmerica and their 10 official guests came from USA, Italy and Chile (http://radla2014.com/wp/)
“We are performing more precise and earlier diagnoses”
Even though she is a radiologist and not a dermatologist, doctor Ximena Wortsman is the only Chilean included among the 10 official guests to the XXXII RADLA Santiago 2014 (Annual Meeting of LatinoAmerican Dermatologists). On Saturday, May 3, at 11:00 am, she will present her plenary lecture “New Applications of Color Doppler Ultrasound in Dermatology”.
The reason? The support that color Doppler ultrasound provides to dermatology for knowing “what is happening below and the clinician cannot detect” which can result in better diagnoses.
The director of the Institute for Diagnostic Imaging and Research of the Skin and Soft Tissues (IDIEP) explained that “color Doppler ultrasound is used in a wide range of dermatologic lesions that include benign and malignant tumors, inflammatory diseases, lesions of the nail or scalp, among others. In this lecture she will provide information on the latest applications that have been generated in Chile, from our experience”.
For example, we use ultrasound in the diagnosis and monitoring phase of common inflammatory diseases which is important because we can help to avoid serial biopsies and also help with the cosmetic prognosis of the patient. Besides this, we have novel applications of the use of ultrasound in basal cell carcinoma which is the most frequent (skin) cancer in human beings.
“The expert in radiology occupies a special place in the congress because for dermatology this represents an important contribution that has caused a revolution because it shows us things inside, that we cannot see from outside“ said the president of the RADLA 2014 congress Dr. Ivan Jara.
Dr Wortsman explained that the “objective of imaging is to provide useful information that a well trained clinician, however good, cannot detect from the physical examination. So we can reveal the hidden part of the problem. Our work is also to detail the anatomical findings in such a way that this ultrasound analysis may be reproducible in the future”.
“I believe that my specialty has helped because we are giving more precise and earlier diagnoses and in that sense imaging can be a great support to the clinical work”.
Dr Ximena Wortsman affirmed that the back up from the dermatology field has allowed her to carry out better work and progress professionally, adding that this great collaboration between the dermatologic and imaging field should be maintained and deepened.
“I have had the great luck to have the luxury of the support of the high level of Chilean dermatology which has been fundamental for the development of this work. The idea is to generate teams where there is fusion between the information provided by imaging or radiology and clinical dermatology, since this is fundamental for further advances” Dr. Wortsman concluded.