Dermatologic Ultrasound Applications for Management
Dermatologic Ultrasound has seen significant growth in the past decade, largely due to advancements in technology, such as higher-frequency probes. This imaging technique has become invaluable in the diagnosis and management of various dermatologic conditions, including benign and malignant skin tumors, vascular anomalies, inflammatory disorders, aesthetic complications, and nail lesions. With axial spatial resolution much higher than that of computed tomography (CT) or magnetic resonance imaging (MRI), ultrasonography can distinguish submillimeter structures. The axial resolution ranges from 100 microns at 18 MHz to 30 microns at 70 MHz, making it suitable for detailed skin imaging.
Ultrasonography offers advantages
Ultrasonography offers advantages in early diagnosis, tracking disease activity, and assessing severity, which aids in personalized patient treatment. Devices with color Doppler and multifrequency probes (≥15 MHz) are recommended. Some active counterparts reach frequencies up to 70 MHz for superior resolution.
Ultrasonography’s ability to visualize skin layers offers critical insights. The epidermis appears as a hyperechoic line, especially thicker and bilaminar in the palms and soles due to keratin content. The dermis is a hyperechoic band that is less bright than the epidermis and contains collagen. It varies in thickness across body areas, with a hypoechoic band in photoaging, which should not be mistaken for inflammation. The hypodermis (subcutaneous tissue) shows as a hypoechoic layer with fatty tissue and fibrous septa. This technique, when performed according to medical guidelines, can significantly improve diagnosis and treatment, enhancing patient outcomes.
