Current applications of high-frequency ultrasonography in dermatology

Abstract

The era of ultrasounds in dermatology started in 1979, when pioneering use of 15 MHz by Alexander and Miller in measuring the skin thickness was introduced. Since then, some new applications of high-frequency ultrasonography (HF-USG) have emerged providing the clinicians with an extra hand in their everyday practice. The main advantages of HF-USG include the possibility of real-time imaging, measurements of morphological and physiological aspects of the skin, safety associated with the use of non-ionizing media as well as the lack of contraindications to its performance. Currently the main clinical use of HF-USG in dermatology regards preoperative assessment of the depth of invasion in melanomas and basal cell carcinomas. The ultrasound image analysis allows noninvasive follow-up of inflammatory skin diseases, like atopic dermatitis, psoriasis and may be used for monitoring effectiveness of therapy in skin lymphomas and sclerotic skin diseases.

Sonographic appearance of sebaceous cysts. Our experience and a review of the literature

“…Given the limitations of retrospective series evaluation, our study has confirmed the importance of using high frequency probes in evaluating skin lesions also for sebaceous cysts, for better characterization and, consequently, better differential diagnosis, which is fundamental in patients with multiple and concurrent dermatological diseases in everyday clinical practice . In our experience with higher frequency probes and in more significant case series, the morphostructural characteristics described in the literature for the diagnosis of so‐called sebaceous cysts were confirmed, but moreover it showed the high incidence and diagnostic significance of so‐called skin pores, which is a usual finding of these lesions and therefore extremely significant for the differential diagnosis of this disease …”

High‐frequency ultrasonography a new quantitative method in evaluation of skin lymphomas—First comparative study in relation to histopathology

“…The difference between measurements (ultrasonographic and histometric) may be related to the shrinkage of the specimen during its preparation. This problem was observed previously in relation to BCC and melanomas . It was reported before, that routine histology process may distort anatomy of the skin and result in contraction of the tissue—particularly evident for the dermis (especially in relation to elastic fibers) and, what is more, ultrasound in vivo measurement was proposed as more reliable method in the determination of true tumor extent …”

“…Subepidermal low echogenic band is a sonographic phenomenon highlighting the presence of the subepidermal anechogenic or low echogenic band underneath the entrance echo and has low specificity . Its first description was in 1989 by de Rigal et al within sun‐exposed skin.…”

“…The border between dermis and subcutaneous tissue is easily detected since the second one is least echogenic. The echogenicity of the abovementioned may vary according to the different processes affecting skin …”

Ultrasonographic elastography in the evaluation of normal and pathological skin – a review

“…Chronic inflammation alters the presentation of skin not only in conventional B-mode ultrasonography, highfrequency ultrasonography [47] and Doppler imaging, but also in elastography [48]. A study of 50 patients with skin abscesses demonstrated that SE may be used to detect stiff areas at the periphery of the lesions, which could not be visualized with conventional B-mode sonography [28].…”