Textbook of Dermatologic Ultrasound

Foreword
Preface
Acknowledgments
Contents
Contributors
Part I: The Requisites
	1: Technical Recommendations, Settings, Protocols, Training, and Reports of the Dermatologic Ultrasound Examinations
		Introduction
		Recommendations and Relevant Points
		How to Improve the Learning of Dermatologic Ultrasound
		Protocols for Performing Dermatologic Ultrasound Examinations
			Sedation
			Technique for the Dermatologic Ultrasound Examination
		Training of Dermatologic Ultrasound
			Main Concepts
			Assessment of Competence and Operators in Charge of the Examination
			Major Advantages of the Dermatologic Ultrasound Examinations
			Major Limitations
		Main Applications
		Reporting the Examinations
		Common Issues in Dermatologic Ultrasound
		Special Protocols
			Protocol for the Nail
			Protocol for the Scalp
			Protocol for Patients with History of Aesthetic Procedures of the Face
			Protocol for Hidradenitis Suppurativa
			Protocol for Morphea
			Other Useful Tips
		Settings for Dermatologic Lesions
		Conclusion
		References
	2: Training in Dermatologic Ultrasound
		Introduction
		Towards a Structured Curriculum for Dermatologic Ultrasound Teaching
		Practical Considerations Regarding Course Organization in Dermatologic Ultrasound
		Dermatologic Ultrasound According to Academic Degree or Specialization
			Pregrade Medicine Students
			Dermatology and Radiology Residents
			Dermatologic Ultrasound for Specialists
			Dermatologic Ultrasound for Primary Care Practitioners
		Accreditation in Dermatologic Ultrasound
		Conclusions
		References
	3: Dermatologic Concepts and Terminology
		Initial Approach to Skin Lesions
		Dermatopathological Terms
		Glossary of Common Dermatologic Disorders
			A
			B
			C
			D
			E
			F
			G
			H
			I
			J
			K
			L
			M
			N
			O
			P
			R
			S
			T
			U
			V
			W
			X
		Common Dermatologic Signs
		Differential Diagnosis of Skin Disorders According to Lesion Morphology and Affected Region
		Relevant Scoring Systems in Dermatology
			Hidradenitis Suppurativa
			Malignant Melanoma
			Psoriasis
			Atopic Dermatitis
			Toxic Epidermal Necrolysis/Stevens-Johnson Syndrome
			Systemic Sclerosis
			Lupus Erythematosus
		References
	4: Ultrasound Imaging: Basic Principles and Terminology
		Introduction
		Basic Acoustics and Instrumentation
			Grayscale Ultrasound Imaging
			Doppler Sonography
			Ultrasound Transducers
			Software Developments
				Tissue Harmonic Imaging
				Spatial Compounding Imaging
				Extended Field of View (EFOV)
				Three-Dimensional (3D) Imaging
				Elastography
				Contrast-Enhanced Ultrasound
				Microvascularity
				Fusion Imaging
		Operator Performance
		Future Directions
		Tips and Teaching Points
		Useful Glossary of Ultrasound
		Conclusion
		References
	5: Comprehensive Ultrasonographic Anatomy of the Normal Skin, Nail, Hair, and Adjacent Structures
		Introduction
		Skin
		Hair
		Additional Structures Detected at Ultrahigh Frequency (70 MHz)
			Arrector Pili Muscle
			Sebaceous Glands
			Montgomery Glands
			Apocrine Glands
		Nail
		Adjacent Normal Structures
			Lymph Nodes
			Muscle
			Tendons
			Joints
			Bursae
			Nerves
			Cartilage
			Vessels
			Glands
			Mammary Glands
			Bone Calcium
		Conclusion
		References
	6: Relevant Topographic Anatomy of the Head, Anatomical Variants, and Risk Zones
		Introduction
		Relevant Topographic Anatomy of the Head
			Facial Anatomy
				Muscles of the Face
				Eyelids
				Nose
				Lips
				Ear
		Anatomical Variants
			Salivary Glands
			Main Arteries: Facial, Angular, Labial, Alar, Supratrochlear, Supraorbital, Infraorbital
		Relevant Risk Zones of the Head
			Glabellar Region
			Temple and Lateral Part of the Frontal Region
			Parietotemporal Region
			Preauricular Region
			Infraorbital Region
			Nasofold Region
		References
Part II: Ultrasound Features of Common Dermatologic Conditions
	7: Ultrasound of Congenital Cutaneous Conditions
		Introduction
		Congenital Cutaneous Conditions
			Vascular Origin
				Congenital Hemangiomas
				Rapidly Involuting (RICH)
				Non-involuting (NICH)
				Partially Involuting (PICH)
		Other Ultrasonographic Features of Congenital Hemangiomas
			Vascular Malformations (VMs)
		Congenital Syndromes with Vascular Malformations
			Cysts
				Branchial Cysts or Fistulas
				Thyroglossal Cysts
				Dermoid Cysts
				Auricular Pits and Fistulas (Sinuses)
			Aplasia Cutis Congenita (ACC)
			Nevus Sebaceous of Jadassohn (NSJ)
			Neurofibromatosis (NF)
			Lipofibromatous Hamartoma
			Ichthyosis
		References
	8: Nonvascular Benign Tumors and Pseudotumors
		Introduction
		Nonvascular Benign Tumors and Pseudotumors
			Cystic
				Epidermal or Inclusion Cyst
				Trichilemmal Cyst
				Pilonidal Cyst
				Nodular Hidradenoma
				Hidrocystoma
				Chalazion
				Steatocystoma Multiplex
			Solid
				Lipoma
				Pilomatrixoma
				Dermatofibroma
				Nodular Fasciitis
				Nodular Pseudolymphoma
				Keloids
		Conclusion
		References
	9: Essential Concepts on Ultrasonography of Skin Cancer
		Introduction
		Non-melanoma Skin Cancers
			Basal Cell Carcinoma (BCC)
			Squamous Cell Carcinoma (SCC)
			Dermatofibrosarcoma Protuberans (DFSP)
			Merkel Cell Tumor
			Primary Cutaneous Lymphomas
			Liposarcomas
		Melanoma
		References
	10: Ultrasound of Cutaneous Melanoma: Primary Tumor Assessment and Locoregional Staging
		Introduction
		Epidemiological and Clinical Aspects of Cutaneous Melanoma
			Prevalence and Mortality
			Pathology and Classification: The Breslow Index
			Patterns of Growth and Patterns of Spread
			Diagnosis and Management
		Tips and Tricks of Cutaneous Melanoma US Examination
			Technological Requirements
			Primary Tumor Examination
			Locoregional Examination
		Primary Cutaneous Melanoma: US Findings
		Role of US in Primary Cutaneous Melanoma
			Differential Diagnosis
			Measuring Tumor Thickness
			Prognosis
		Cutaneous Melanoma Staging
		The Sentinel Lymph Node Biopsy
			Conceptual Aspects
			Description of the Procedure
			Post-SLNB Patient Management
			US and the SLNB
		Satellite, In-Transit, and Lymph Node Melanoma Metastasis: US Findings
			US Imaging of Satellite/In-Transit Metastasis
			US Imaging of Lymph Node Metastasis
		Cutaneous Melanoma Follow-Up
		US Guidance for Diagnostic and Therapeutic Procedures
		Response to Treatment
		US of Cutaneous Melanoma: Challenging Aspects and Essential Requirements
		Conclusions and Future Perspectives
		References
	11: Ultrasound of Cutaneous Lymphomas
		Conclusion
		References
	12: Use of Ultrasound in Cryosurgical Treatment
		Introduction
		The Need for a Variety of Therapeutic Approaches and the Role of HFUS
		Cryotherapy as a Treatment Option for Keratinocyte Carcinomas
			Trans-Cryosurgical Control with HFUS
			Cryobiopsy and Ex Vivo HFUS
			Contraindications
		Conclusions
		References
	13: Basal Cell Carcinoma Ultrasound Examination with 20 and 75 MHz High-Frequency Ultrasound
		Introduction
		Literature Review
		Clinical Cases
			Case 1
			Clinical Case 2
			Clinical Case 3
			Case 4
			Case 5
			Case 6
		Conclusion
		References
	14: Role of Ultrasound at 50 MHz in Skin Cancer
		Basal Cell Carcinoma
		Squamous Cell Carcinoma
		Malignant Melanoma
		Primary Cutaneous Lymphoma
		References
	15: Role of Ultrasound at 70 MHz in Skin Cancer
		Introduction
		Melanoma
		Non-melanoma Skin Cancers
		Cutaneous Lymphomas
		Dermatofibrosarcoma Protuberans (DFSP)
		Nevus Sebaceous of Jadassohn
		Conclusion
		References
	16: Ultrasound of Vascular Tumors
		Introduction
		Benign Tumors
			Hemangiomas
				Infantile Hemangiomas
				Congenital Hemangiomas
			Angiokeratoma-Verrucous Hemangioma
			Glomus Tumor-Glomangioma-Glomuvenous Malformation
				Glomus Tumor
				Glomangiomas
				Glomuvenous Malformations
			Pyogenic Granuloma
			Angiolymphoid Hyperplasia with Eosinophilia
			Kaposiform Hemangioendothelioma
		Malignant
			Angiosarcoma
			Kaposi’s Sarcoma
		Conclusion
		References
	17: Main Concepts on Ultrasonography of Dermatologic Inflammatory Conditions
		Introduction
		Considerations on the Ultrasound Examination Protocol of Inflammatory Conditions
		Cutaneous Inflammatory Conditions
			Edema and Lymphedema
			Seromas, Hematomas, and Serohematomas
			Abscesses and Fistulous Tracts
				Odontogenic Fistula
			Panniculitis
			Morphea
			Cutaneous Lupus
			Dermatomyositis
			Psoriasis
			Acne
			Rosacea
			Hidradenitis Suppurativa (HS)
			Foreign Bodies
		References
	18: Clinical Overview of Inflammatory Dermatologic Conditions
		Introduction
		Cutaneous Lupus Erythematosus
		Morphea
		Dermatomyositis
		Raynaud’s Phenomenon
		Vasculitis of the Skin
		Cutaneous Involvement in Inflammatory Bowel Diseases
		References
	19: Clinical Overview of Psoriasis and Psoriatic Arthritis
		Epidemiology
		Etiopathogenesis
		Histopathology
		Clinical Manifestations
			Clinical Variants
			Treatment
		References
	20: Ultrasound of Common Infestations and Infections
		Introduction
		Myiasis
		Larva Migrans
		Cutaneous Tuberculosis
		Leishmaniasis
		Leprosy
		Mycetomas
		Hyalohyphomycosis
		Phaeohyphomycosis
		Warts
		References
	21: Ultrasound of Nail Conditions
		Introduction
		Benign Pathology
			Tumors and Pseudotumors
				Ungual
					Solid
						Glomus Tumor
						Onychomatricoma
						Fibroma
						Neurogenic Tumors: Schwannoma and Perineurioma
						Keratoacanthoma
						Granuloma
					Cystic
						Mucous Cysts
				Periungual
					Solid
						Periungual Fibroma: Acquired Ungual Fibrokeratoma
						Exostosis
						Periungual Granuloma
					Cystic
						Myxoid or Synovial Cyst
			Inflammatory Conditions
				Psoriasis
				Lupus
				Rheumatoid Arthritis
				Dermatomyositis
				Scleroderma
				Fluid Collections
				Median Canaliform Dystrophy
				Subungual Wart
			Growth Alterations
				Congenital
					Malalignment
					Cystic Fibrosis
				Acquired
					Onychocryptosis
					Onychomadesis
					Retronychia
		Malignant Pathology
			Squamous Cell Carcinoma
			Melanoma
		References
	22: Ultrasound in Aesthetics
		Introduction
		Cosmetic Fillers
			Detection and Identification of Cosmetic Fillers
				Anechoic
					Hyaluronic Acid
					Polyacrylamide Gel (PAAG)
					Pure Silicone
				Hypoechoic or Heterogeneous
					Polycaprolactone
				Hyperechoic
					Silicone Oil
					Polymethylmethacrylate (PMMA)
					Calcium Hydroxyapatite (CaOH)
			Assessment of the Location and Extent of Cosmetic Fillers
			Complications of Cosmetic Fillers
				Early Complications
					Immediate Complications
					Intermediate Complications
					Management of Early Complications
				Late Complications
					Chronic Inflammation
					Granulomatous Reaction
					Sarcoid Reaction
					Panniculitis
					Morphea and Morphea-Like Reactions
					Lumps and Bumps
					Inflammation of the Lacrimal, Parotid, and Submandibular Glands
		Nonsurgical Aesthetic Procedures
			Mesotherapy
			Cryolipolysis
			Radiofrequency
			Autologous Fat Grafting
			Tensor Threads
				Implants
		Surgical Aesthetic Procedures
			Liposuction
			Abdominoplasty
			Blepharoplasty
			Rhinoplasty
		References
	23: Cutaneous Ultrasonography in Pediatric Dermatology
		Introduction
			Generalities
			Environment, Distraction, and Sedation
		Nonvascular Tumors and Hamartomas
			Nonvascular Tumors
				Benign Tumors
					Neurofibroma
					Lipoblastoma
					Pilomatricoma
					Syringocystadenoma Papilliferum
					Fibrous Hamartoma of Infancy (FHI)
					Infantile Myofibroma
					Superficial Angiomyxoma
					Juvenile Xanthogranuloma
				Malignant Tumors
					Metastatic Neuroblastoma
					Plexiform Fibrohistiocytic Tumor
					Infantile Fibrosarcoma
					B-Cell Lymphoblastic Lymphoma (BcLL)
			Hamartomas
				Nevus Sebaceous of Jadassohn
				Cutaneous Smooth Muscle Hamartoma (CSMH)/Becker’s Nevus
				Cutaneous Fibrolipomatous Hamartoma
		Inflammatory Lesions
			Subcutaneous Fat Necrosis of the Newborn (SCFN)
			Idiopathic Facial Aseptic Granuloma (IFAG)
			Subcutaneous Granuloma Annulare
			Linear Morphea
			Segmental Stiff Skin Syndrome
		Vascular Lesions
			Tumors
				Lobular Capillary Hemangioma (Pyogenic or Telangiectatic Granuloma)
				Infantile Hemangioma (IH)
				Congenital Hemangioma (CH)
				Tufted Angioma (TA) and Kaposiform Hemangioendothelioma (KHE)
			Vascular Malformations
				Fast Flow (High Flow)
					Arteriovenous Malformation (AVM)
				Low Flow
					Capillary Malformations (CM)
					Venous Malformation (VM)
					Lymphatic Malformations (LM)
		Other Embryological Developmental Anomalies
			Aplasia Cutis Congenita (ACC)
			Sinus Pericranii (SP)
			Cephalocele and Atretic Cephalocele
			Cysts, Sinuses, and Fistulae
				Dermoid Cyst (DC)
				Preauricular Sinus/Fistula (PS)
				Branchial Cleft Anomalies
				Thyroglossal Duct Cyst (TGDC)
				Midline Anterior Neck Inclusion Cyst (MANIC)
				Bronchogenic Cyst
				Congenital Sternoclavicular Sinus
				Spinal Dermal Sinus Tract (DST)
				Spinal Pseudo-Dermal Sinus Tract (PDST) or Spinal Dermal Sinus-Like Stalk
		Miscellanea
			Foreign Bodies
				Hair-Thread Tourniquet Syndrome
				Delayed Granulomatous Reaction Induced by Retained Electrodes from a Cardiac Pacemaker
				Iatrogenic Calcinosis Cutis
			Hematomas
				Soft-Tissue Hematomas
				Neonatal Scalp Hematoma
					Caput Succedaneum
					Cephalohematoma
					Subgaleal Hematoma
		References
Part III: Practicalities
	24: Tips for Reporting Dermatologic Ultrasound Examinations
		Introduction
		Relevant Information in the Report
		Examples of Reports
			Reporting an Epidermal Cyst
				History
				Technique
				Report
				Ultrasonographic Impression
			Reporting a Pilomatrixoma
				History
				Technique
				Report
				Ultrasonographic Impression
			History
				History
				Technique
				Report
				Ultrasonographic Impression
			Reporting a Plantar Wart
				History
				Technique
				Report
				Ultrasonographic Impression
			Reporting an Infantile Hemangioma
				History
				Technique
				Report
				Ultrasonographic Impression
			Reporting a Vascular Malformation
				History
				Technique
				Report
				Ultrasonographic Impression
			Reporting a Morphea
				History
				Technique
				Report
				Ultrasonographic Impression
			Reporting a Hidradenitis Suppurativa
				History
				Technique
				Report
				Ultrasonographic Impression
			Reporting a Nail Psoriasis
				History
				Technique
				Report
				Ultrasonographic Impression
			Reporting Cosmetic Fillers
				History
				Technique
				Report
				Ultrasonographic Impression
			Reporting a Basal Cell Carcinoma
				History
				Technique
				Report
				Ultrasonographic Impression
			Reporting a Melanoma
				History
				Technique
				Report
				Ultrasonographic Impression
		References
	25: Ultrasound Intervention in Tumors, Pseudotumors, and Vascular Soft-Tissue Lesions
		Ultrasound as a Technique to Guide Procedures
		Biopsy
			Technique
			Outcome
		Percutaneous Treatment of Fluid-Filled Lesions
			Ganglion Cysts
				Treatment
				Outcome
			Bursitis
				Treatment
				Outcome
		Percutaneous Treatment of Dupuytren’s Disease
			US-Guided Percutaneous Needle Fasciotomy
			Outcome
		Percutaneous Treatment of Arteriovenous Malformations
			Percutaneous Sclerotherapy
		Percutaneous Intervention on Cosmetic Fillers
			Complications of Cosmetic Fillers and Treatment
				Allergic Reactions
				Displacement of the Fillers
		Foreign Bodies’ Removal
			Ultrasound-Guided Removal of Foreign Bodies
		References
	26: Ultrasound-Assisted Hidradenitis Suppurativa Procedures
		Introduction
		Intralesional Drug Infiltrations
		Delimitation of the Extent of the Surgical Area with Ultrasound in HS
		References
	27: Interventional Dermatologic Ultrasound in Aesthetics
		Interventional Dermatologic Ultrasound: Aesthetics
		References
	28: The Role of Ultrasound in the Use of Hyaluronidase
		Introduction
		Recognition of Hyaluronic Acid by Ultrasound Imaging
		Ultrasound-Guided Injections to Resolve Complications in Hyaluronic Acid Fillers
		Prevention of Complications: Pre-Treatment Assessment
		Other Filler Complications
		References
Appendix: Self Assessment Modules (CME Questions)
	CME Questions: Technical Recommendations (Ximena Wortsman, Fernando Alfageme)
	CME Questions: Dermatologic Concepts and Terminology (Diana Crisan, Maria Crisan)
	CME Questions: Ultrasound Maging: Basic Concepts and Terminology (Diana Gaitini)
	CME Questions: Normal Anatomy (Ximena Wortsman)
	CME Questions: Relevant Topographic Anatomy of the Head, Anatomical Variants, and Risk Zones (Ximena Wortsman)
	CME Questions: Congenital (Ximena Wortsman)
	CME Questions: Benign Nonvascular Tumors (Ximena Wortsman)
	CME Questions: Skin Cancer (Ximena Wortsman)
	CME Questions: Vascular Tumors (Ximena Wortsman)
	CME Questions: Inflammatory (Ximena Wortsman)
	CME Questions: Infestations and Infections (Ximena Wortsman)
	CME Questions: Ultrasound of Nail Conditions (Ximena Wortsman)
	CME Questions: Aesthetics (Ximena Wortsman)
	CME Questions: Pediatric Dermatology (Ximena Wortsman)
	CME Questions: Interventional (Jose Luis del Cura, Gorka del Cura, Ximena Wortsman)
Index