The objective of this paper is to assess the role of conventional and high-frequency ultrasound in the evaluation of the depth of cutaneous skin cancer. The study was performed on 46 subjects, divided into 3 categories, according to their skin pathology [basal cell carcinoma (BCC), 18 subjects; superficial spreading melanoma (SSM), 8 subjects; nodular melanoma (NM), 20 subjects]. Conventional and high-frequency ultrasonographic measurements were performed in order to assess the thickness of the tumors and the vascularization degree. We compared the mean values of the tumoral thickness obtained by using ultrasound (ultrasonographic depth index) with the histological depth index, obtained after performing histological sections stained with hematoxylin-eosin, and specific monoclonal antibodies in case of pigmented tumors. We established a correlation index between the histological and ultrasonographic values of the tumoral thickness. We found a strong correlation between the ultrasonographic index (measured by high-frequency sonography) and the histological index for nodular BCC (correlation of 98.4 %), NM subjects (correlation of 98.4 %), and SSM subjects (correlation of 99.4 %). An increase of the blood supply was noticed in nodular lesions only. Ultrasonography allows a very accurate assessment of skin cancer. The ultrasonographic depth index can be considered an objective, non-invasive marker for cutaneous tumors, comparable to the histological one, with a very good sensitivity (98-99 %).

Dermatologic ultrasound is a recent application of ultrasound for the evaluation of healthy skin and appendages and their diseases. Although the scientific literature regarding this application is still not sufficient for evidence-based guidelines, general recommendations issued by scientific societies are necessary. The EFSUMB (European Federation of Societies for Ultrasound in Medicine and Biology) steering committee for dermatologic ultrasound has developed a series of consensus position statements regarding the main fields of dermatologic ultrasound (technical requirement, normal skin and appendages, inflammatory skin diseases, tumoral skin diseases, aesthetic dermatology and practice-training requirements). This document is the foundation for future evidence-based recommendations and guidelines for dermatologic ultrasound practice.

High-frequency ultrasound is a noninvasive "histological" tool that can assess the cutaneous structure and age-related changes. It offers imagistic markers, comparable to the histological parameters and also characteristic ultrasonographic markers. Histology remains the gold standard for the investigation of the integumentary system.

BackgroundImagistic methods stand as modern, non-invasive, and objective means of assessing the impact of topical cutaneous therapies.ObjectiveThis study focuses on the evaluation, by high-frequency ultrasound, of the cutaneous changes induced by topical use of a vitamin C complex at facial level.MethodsA vitamin C-based solution/Placebo moisturizer cream was applied at facial level of 60 healthy female subjects according to a predetermined protocol. Ultrasonographic images (Dermascan C, 20 MHz) were taken from zygomatic level initially, at 40 and 60 days after therapy. The following parameters were assessed for every subject: thickness of the epidermis and dermis (mm), the number of low (LEP), medium (MEP), high echogenic pixels (HEP), and the number of LEP in the upper dermis/lower dermis (LEPs/LEPi).ResultsLEP decreased significantly in all age categories during and after therapy, but especially in the first 2 age intervals, up to the age of 50 (P=0.0001). MEP and HEP, pixel categories that quantify protein synthesis also had an age-dependent evolution in the study, increasing significantly in all age categories but most of all in the first age interval (P=0.002). Our ultrasonographic data suggest that collagen synthesis increased significantly after topical vitamin C therapy, and is responsible for the increase in MEP and HEP and consequent decrease of the LEP.ConclusionOur study shows that topically applied vitamin C is highly efficient as a rejuvenation therapy, inducing significant collagen synthesis in all age groups with minimal side effects.

New biomaterials based on nanoparticles (NPs) carrying polyphenols-rich extracts (Cornus mas) recently showed promising anti-inflammatory activity in psoriasis. We aimed to understand how topically delivered silver and gold nanoparticles complexed with Cornus mas (Ag-NPs-CM, Au-NPs-CM) modulate inflammation in psoriasis at cellular and molecular level. The impact on psoriatic inflammation was assessed in vitro on pro-inflammatory macrophages, by clinical score, high-frequency ultrasonography and immunohistology of psoriasis plaques treated with Ag-NPs-CM, Au-NPs-CM or control. Incubation of pro-inflammatory macrophages with nanoparticles significantly decreased the release of NO, IL-12 and TNF-α. Immunofluorescence confirmed that nanoparticles significantly reduced CD68-positive macrophages and their IL-12 and TNF-α production in human psoriasis plaques. NPs-CM appear to repress NF-κB activation in macrophages, inhibiting the production of pro-inflammatory factors with causal role in psoriasis. Ag and Au NPs-CM represent a novel nanoparticle-based "green" technology which may provide an efficient tool for modern psoriasis therapy, circumventing immunosuppression-related side effects of biologicals.