title: Guidelines for Performing Dermatologic Ultrasound Examinations by the DERMUS Group.
abstract: OBJECTIVE
  To support standardization for performing dermatologic ultrasound examinations.
  
  
  METHODS
  An international working group, called DERMUS (Dermatologic Ultrasound), was formed, composed of physicians who have been working on a regular basis and publishing in peer-reviewed articles on dermatologic ultrasound. A questionnaire on 5 critical issues about performance of the examinations was prepared and distributed by e-mail. The areas of discussion included technical aspects, main areas of application, minimum number of examinations per year required for assessing competence, qualifications of the personnel in charge of the examination, and organization of courses. Final recommendations were approved on the basis of the agreement of more than 50% of the members.
  
  
  RESULTS
  The minimum frequency recommended for performing dermatologic examinations was 15 MHz. Routine use of color Doppler ultrasound and the performance of spectral curve analysis for assessing the main vascularity of lesions were suggested. Three-dimensional reconstructions were considered optional. The main dermatologic applications were benign tumors, skin cancer, vascular anomalies, cosmetic field, nail disorders, and inflammatory diseases. The minimum number of examinations per year suggested by the group for assessing competence was 300. A physician and not a sonographer was recommended to be the person in charge of performing the examination. On course organization, a minimum of 2 levels of complexity (basic and advanced) was suggested.
  
  
  CONCLUSIONS
  There is a need to standardize the performance and quality of dermatologic ultrasound examinations. The present guidelines written by an international group of specialists in the field may support this objective.
authors.affiliation: Departments of Radiology and Dermatology, Institute for Diagnostic Imaging and Research of the Skin and Soft Tissues, Clinica Servet, Faculty of Medicine, University of Chile, Santiago, Chile (X.W.); Department of Dermatology, Hospital Puerta del Hierro, Madrid, Spain (F.A., G.R.); Department of Dermatology, Virgen de las Nieves University Hospital, Granada, Spain (S.A.-S.); Department of Dermatology, Hospital de Manises, Valencia, Spain (A.Mar.); Department of Radiology, National Cancer Institute Fondazione Pascale, Naples, Italy (O.C.); Department of Radiology, Università Degli Studi di Napoli Federico II, Naples, Italy (M.S.d.S.); Department of Dermatology, Roskilde Hospital, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark (K.Z.); Department of Radiology, Hospital das Clínicas da Faculdade de Medicina de São Paulo, São Paulo, Brazil (M.B.); Department of Radiology, Instituto de Diagnóstico Médico, Instituto de Imágenes Diagnósticas, Bogota, Colombia (C.G.); Bard Cancer Center, New York, New York USA (R.B.); Department of Radiodiagnosis, Central Hospital, South Central Railway, Telangana, India (A.Man.); and Department of Medical Imaging, Rambam Health Care Centre, Haifa, Israel (D.G.). xworts@yahoo.com.
authors.forename: Ximena
authors.initials: X
authors.lastname: Wortsman
authors.affiliation: Departments of Radiology and Dermatology, Institute for Diagnostic Imaging and Research of the Skin and Soft Tissues, Clinica Servet, Faculty of Medicine, University of Chile, Santiago, Chile (X.W.); Department of Dermatology, Hospital Puerta del Hierro, Madrid, Spain (F.A., G.R.); Department of Dermatology, Virgen de las Nieves University Hospital, Granada, Spain (S.A.-S.); Department of Dermatology, Hospital de Manises, Valencia, Spain (A.Mar.); Department of Radiology, National Cancer Institute Fondazione Pascale, Naples, Italy (O.C.); Department of Radiology, Università Degli Studi di Napoli Federico II, Naples, Italy (M.S.d.S.); Department of Dermatology, Roskilde Hospital, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark (K.Z.); Department of Radiology, Hospital das Clínicas da Faculdade de Medicina de São Paulo, São Paulo, Brazil (M.B.); Department of Radiology, Instituto de Diagnóstico Médico, Instituto de Imágenes Diagnósticas, Bogota, Colombia (C.G.); Bard Cancer Center, New York, New York USA (R.B.); Department of Radiodiagnosis, Central Hospital, South Central Railway, Telangana, India (A.Man.); and Department of Medical Imaging, Rambam Health Care Centre, Haifa, Israel (D.G.).
authors.forename: Fernando
authors.initials: F
authors.lastname: Alfageme
authors.affiliation: Departments of Radiology and Dermatology, Institute for Diagnostic Imaging and Research of the Skin and Soft Tissues, Clinica Servet, Faculty of Medicine, University of Chile, Santiago, Chile (X.W.); Department of Dermatology, Hospital Puerta del Hierro, Madrid, Spain (F.A., G.R.); Department of Dermatology, Virgen de las Nieves University Hospital, Granada, Spain (S.A.-S.); Department of Dermatology, Hospital de Manises, Valencia, Spain (A.Mar.); Department of Radiology, National Cancer Institute Fondazione Pascale, Naples, Italy (O.C.); Department of Radiology, Università Degli Studi di Napoli Federico II, Naples, Italy (M.S.d.S.); Department of Dermatology, Roskilde Hospital, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark (K.Z.); Department of Radiology, Hospital das Clínicas da Faculdade de Medicina de São Paulo, São Paulo, Brazil (M.B.); Department of Radiology, Instituto de Diagnóstico Médico, Instituto de Imágenes Diagnósticas, Bogota, Colombia (C.G.); Bard Cancer Center, New York, New York USA (R.B.); Department of Radiodiagnosis, Central Hospital, South Central Railway, Telangana, India (A.Man.); and Department of Medical Imaging, Rambam Health Care Centre, Haifa, Israel (D.G.).
authors.forename: Gaston
authors.initials: G
authors.lastname: Roustan
authors.affiliation: Departments of Radiology and Dermatology, Institute for Diagnostic Imaging and Research of the Skin and Soft Tissues, Clinica Servet, Faculty of Medicine, University of Chile, Santiago, Chile (X.W.); Department of Dermatology, Hospital Puerta del Hierro, Madrid, Spain (F.A., G.R.); Department of Dermatology, Virgen de las Nieves University Hospital, Granada, Spain (S.A.-S.); Department of Dermatology, Hospital de Manises, Valencia, Spain (A.Mar.); Department of Radiology, National Cancer Institute Fondazione Pascale, Naples, Italy (O.C.); Department of Radiology, Università Degli Studi di Napoli Federico II, Naples, Italy (M.S.d.S.); Department of Dermatology, Roskilde Hospital, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark (K.Z.); Department of Radiology, Hospital das Clínicas da Faculdade de Medicina de São Paulo, São Paulo, Brazil (M.B.); Department of Radiology, Instituto de Diagnóstico Médico, Instituto de Imágenes Diagnósticas, Bogota, Colombia (C.G.); Bard Cancer Center, New York, New York USA (R.B.); Department of Radiodiagnosis, Central Hospital, South Central Railway, Telangana, India (A.Man.); and Department of Medical Imaging, Rambam Health Care Centre, Haifa, Israel (D.G.).
authors.forename: Salvador
authors.initials: S
authors.lastname: Arias-Santiago
authors.affiliation: Departments of Radiology and Dermatology, Institute for Diagnostic Imaging and Research of the Skin and Soft Tissues, Clinica Servet, Faculty of Medicine, University of Chile, Santiago, Chile (X.W.); Department of Dermatology, Hospital Puerta del Hierro, Madrid, Spain (F.A., G.R.); Department of Dermatology, Virgen de las Nieves University Hospital, Granada, Spain (S.A.-S.); Department of Dermatology, Hospital de Manises, Valencia, Spain (A.Mar.); Department of Radiology, National Cancer Institute Fondazione Pascale, Naples, Italy (O.C.); Department of Radiology, Università Degli Studi di Napoli Federico II, Naples, Italy (M.S.d.S.); Department of Dermatology, Roskilde Hospital, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark (K.Z.); Department of Radiology, Hospital das Clínicas da Faculdade de Medicina de São Paulo, São Paulo, Brazil (M.B.); Department of Radiology, Instituto de Diagnóstico Médico, Instituto de Imágenes Diagnósticas, Bogota, Colombia (C.G.); Bard Cancer Center, New York, New York USA (R.B.); Department of Radiodiagnosis, Central Hospital, South Central Railway, Telangana, India (A.Man.); and Department of Medical Imaging, Rambam Health Care Centre, Haifa, Israel (D.G.).
authors.forename: Antonio
authors.initials: A
authors.lastname: Martorell
authors.affiliation: Departments of Radiology and Dermatology, Institute for Diagnostic Imaging and Research of the Skin and Soft Tissues, Clinica Servet, Faculty of Medicine, University of Chile, Santiago, Chile (X.W.); Department of Dermatology, Hospital Puerta del Hierro, Madrid, Spain (F.A., G.R.); Department of Dermatology, Virgen de las Nieves University Hospital, Granada, Spain (S.A.-S.); Department of Dermatology, Hospital de Manises, Valencia, Spain (A.Mar.); Department of Radiology, National Cancer Institute Fondazione Pascale, Naples, Italy (O.C.); Department of Radiology, Università Degli Studi di Napoli Federico II, Naples, Italy (M.S.d.S.); Department of Dermatology, Roskilde Hospital, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark (K.Z.); Department of Radiology, Hospital das Clínicas da Faculdade de Medicina de São Paulo, São Paulo, Brazil (M.B.); Department of Radiology, Instituto de Diagnóstico Médico, Instituto de Imágenes Diagnósticas, Bogota, Colombia (C.G.); Bard Cancer Center, New York, New York USA (R.B.); Department of Radiodiagnosis, Central Hospital, South Central Railway, Telangana, India (A.Man.); and Department of Medical Imaging, Rambam Health Care Centre, Haifa, Israel (D.G.).
authors.forename: Orlando
authors.initials: O
authors.lastname: Catalano
authors.affiliation: Departments of Radiology and Dermatology, Institute for Diagnostic Imaging and Research of the Skin and Soft Tissues, Clinica Servet, Faculty of Medicine, University of Chile, Santiago, Chile (X.W.); Department of Dermatology, Hospital Puerta del Hierro, Madrid, Spain (F.A., G.R.); Department of Dermatology, Virgen de las Nieves University Hospital, Granada, Spain (S.A.-S.); Department of Dermatology, Hospital de Manises, Valencia, Spain (A.Mar.); Department of Radiology, National Cancer Institute Fondazione Pascale, Naples, Italy (O.C.); Department of Radiology, Università Degli Studi di Napoli Federico II, Naples, Italy (M.S.d.S.); Department of Dermatology, Roskilde Hospital, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark (K.Z.); Department of Radiology, Hospital das Clínicas da Faculdade de Medicina de São Paulo, São Paulo, Brazil (M.B.); Department of Radiology, Instituto de Diagnóstico Médico, Instituto de Imágenes Diagnósticas, Bogota, Colombia (C.G.); Bard Cancer Center, New York, New York USA (R.B.); Department of Radiodiagnosis, Central Hospital, South Central Railway, Telangana, India (A.Man.); and Department of Medical Imaging, Rambam Health Care Centre, Haifa, Israel (D.G.).
authors.forename: Maria
authors.initials: M
authors.lastname: Scotto di Santolo
authors.affiliation: Departments of Radiology and Dermatology, Institute for Diagnostic Imaging and Research of the Skin and Soft Tissues, Clinica Servet, Faculty of Medicine, University of Chile, Santiago, Chile (X.W.); Department of Dermatology, Hospital Puerta del Hierro, Madrid, Spain (F.A., G.R.); Department of Dermatology, Virgen de las Nieves University Hospital, Granada, Spain (S.A.-S.); Department of Dermatology, Hospital de Manises, Valencia, Spain (A.Mar.); Department of Radiology, National Cancer Institute Fondazione Pascale, Naples, Italy (O.C.); Department of Radiology, Università Degli Studi di Napoli Federico II, Naples, Italy (M.S.d.S.); Department of Dermatology, Roskilde Hospital, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark (K.Z.); Department of Radiology, Hospital das Clínicas da Faculdade de Medicina de São Paulo, São Paulo, Brazil (M.B.); Department of Radiology, Instituto de Diagnóstico Médico, Instituto de Imágenes Diagnósticas, Bogota, Colombia (C.G.); Bard Cancer Center, New York, New York USA (R.B.); Department of Radiodiagnosis, Central Hospital, South Central Railway, Telangana, India (A.Man.); and Department of Medical Imaging, Rambam Health Care Centre, Haifa, Israel (D.G.).
authors.forename: Kian
authors.initials: K
authors.lastname: Zarchi
authors.affiliation: Departments of Radiology and Dermatology, Institute for Diagnostic Imaging and Research of the Skin and Soft Tissues, Clinica Servet, Faculty of Medicine, University of Chile, Santiago, Chile (X.W.); Department of Dermatology, Hospital Puerta del Hierro, Madrid, Spain (F.A., G.R.); Department of Dermatology, Virgen de las Nieves University Hospital, Granada, Spain (S.A.-S.); Department of Dermatology, Hospital de Manises, Valencia, Spain (A.Mar.); Department of Radiology, National Cancer Institute Fondazione Pascale, Naples, Italy (O.C.); Department of Radiology, Università Degli Studi di Napoli Federico II, Naples, Italy (M.S.d.S.); Department of Dermatology, Roskilde Hospital, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark (K.Z.); Department of Radiology, Hospital das Clínicas da Faculdade de Medicina de São Paulo, São Paulo, Brazil (M.B.); Department of Radiology, Instituto de Diagnóstico Médico, Instituto de Imágenes Diagnósticas, Bogota, Colombia (C.G.); Bard Cancer Center, New York, New York USA (R.B.); Department of Radiodiagnosis, Central Hospital, South Central Railway, Telangana, India (A.Man.); and Department of Medical Imaging, Rambam Health Care Centre, Haifa, Israel (D.G.).
authors.forename: Marcio
authors.initials: M
authors.lastname: Bouer
authors.affiliation: Departments of Radiology and Dermatology, Institute for Diagnostic Imaging and Research of the Skin and Soft Tissues, Clinica Servet, Faculty of Medicine, University of Chile, Santiago, Chile (X.W.); Department of Dermatology, Hospital Puerta del Hierro, Madrid, Spain (F.A., G.R.); Department of Dermatology, Virgen de las Nieves University Hospital, Granada, Spain (S.A.-S.); Department of Dermatology, Hospital de Manises, Valencia, Spain (A.Mar.); Department of Radiology, National Cancer Institute Fondazione Pascale, Naples, Italy (O.C.); Department of Radiology, Università Degli Studi di Napoli Federico II, Naples, Italy (M.S.d.S.); Department of Dermatology, Roskilde Hospital, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark (K.Z.); Department of Radiology, Hospital das Clínicas da Faculdade de Medicina de São Paulo, São Paulo, Brazil (M.B.); Department of Radiology, Instituto de Diagnóstico Médico, Instituto de Imágenes Diagnósticas, Bogota, Colombia (C.G.); Bard Cancer Center, New York, New York USA (R.B.); Department of Radiodiagnosis, Central Hospital, South Central Railway, Telangana, India (A.Man.); and Department of Medical Imaging, Rambam Health Care Centre, Haifa, Israel (D.G.).
authors.forename: Claudia
authors.initials: C
authors.lastname: Gonzalez
authors.affiliation: Departments of Radiology and Dermatology, Institute for Diagnostic Imaging and Research of the Skin and Soft Tissues, Clinica Servet, Faculty of Medicine, University of Chile, Santiago, Chile (X.W.); Department of Dermatology, Hospital Puerta del Hierro, Madrid, Spain (F.A., G.R.); Department of Dermatology, Virgen de las Nieves University Hospital, Granada, Spain (S.A.-S.); Department of Dermatology, Hospital de Manises, Valencia, Spain (A.Mar.); Department of Radiology, National Cancer Institute Fondazione Pascale, Naples, Italy (O.C.); Department of Radiology, Università Degli Studi di Napoli Federico II, Naples, Italy (M.S.d.S.); Department of Dermatology, Roskilde Hospital, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark (K.Z.); Department of Radiology, Hospital das Clínicas da Faculdade de Medicina de São Paulo, São Paulo, Brazil (M.B.); Department of Radiology, Instituto de Diagnóstico Médico, Instituto de Imágenes Diagnósticas, Bogota, Colombia (C.G.); Bard Cancer Center, New York, New York USA (R.B.); Department of Radiodiagnosis, Central Hospital, South Central Railway, Telangana, India (A.Man.); and Department of Medical Imaging, Rambam Health Care Centre, Haifa, Israel (D.G.).
authors.forename: Robert
authors.initials: R
authors.lastname: Bard
authors.affiliation: Departments of Radiology and Dermatology, Institute for Diagnostic Imaging and Research of the Skin and Soft Tissues, Clinica Servet, Faculty of Medicine, University of Chile, Santiago, Chile (X.W.); Department of Dermatology, Hospital Puerta del Hierro, Madrid, Spain (F.A., G.R.); Department of Dermatology, Virgen de las Nieves University Hospital, Granada, Spain (S.A.-S.); Department of Dermatology, Hospital de Manises, Valencia, Spain (A.Mar.); Department of Radiology, National Cancer Institute Fondazione Pascale, Naples, Italy (O.C.); Department of Radiology, Università Degli Studi di Napoli Federico II, Naples, Italy (M.S.d.S.); Department of Dermatology, Roskilde Hospital, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark (K.Z.); Department of Radiology, Hospital das Clínicas da Faculdade de Medicina de São Paulo, São Paulo, Brazil (M.B.); Department of Radiology, Instituto de Diagnóstico Médico, Instituto de Imágenes Diagnósticas, Bogota, Colombia (C.G.); Bard Cancer Center, New York, New York USA (R.B.); Department of Radiodiagnosis, Central Hospital, South Central Railway, Telangana, India (A.Man.); and Department of Medical Imaging, Rambam Health Care Centre, Haifa, Israel (D.G.).
authors.forename: Anitha
authors.initials: A
authors.lastname: Mandava
authors.affiliation: Departments of Radiology and Dermatology, Institute for Diagnostic Imaging and Research of the Skin and Soft Tissues, Clinica Servet, Faculty of Medicine, University of Chile, Santiago, Chile (X.W.); Department of Dermatology, Hospital Puerta del Hierro, Madrid, Spain (F.A., G.R.); Department of Dermatology, Virgen de las Nieves University Hospital, Granada, Spain (S.A.-S.); Department of Dermatology, Hospital de Manises, Valencia, Spain (A.Mar.); Department of Radiology, National Cancer Institute Fondazione Pascale, Naples, Italy (O.C.); Department of Radiology, Università Degli Studi di Napoli Federico II, Naples, Italy (M.S.d.S.); Department of Dermatology, Roskilde Hospital, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark (K.Z.); Department of Radiology, Hospital das Clínicas da Faculdade de Medicina de São Paulo, São Paulo, Brazil (M.B.); Department of Radiology, Instituto de Diagnóstico Médico, Instituto de Imágenes Diagnósticas, Bogota, Colombia (C.G.); Bard Cancer Center, New York, New York USA (R.B.); Department of Radiodiagnosis, Central Hospital, South Central Railway, Telangana, India (A.Man.); and Department of Medical Imaging, Rambam Health Care Centre, Haifa, Israel (D.G.).
authors.forename: Diana
authors.initials: D
authors.lastname: Gaitini
mesh_terms: D002983:Clinical Competence / Q000592:standards*; D003880:Dermatology / Q000592:standards*; D006801:Humans; D038622:Internationality; D017410:Practice Guidelines as Topic; D012867:Skin / Q000000981:diagnostic imaging*; D012871:Skin Diseases / Q000000981:diagnostic imaging*; D014463:Ultrasonography / Q000592:standards*
keywords: color Doppler dermatology; dermatologic ultrasound; guidelines for dermatologic ultrasound; nail ultrasound; skin ultrasound; superficial structures; ultrasound in dermatology