Skin Ultrasound Imaging
Skin Ultrasound Imaging is an emerging field that has advanced significantly over the past decade. It has diverse applications that can impact patient management, including the evaluation of benign and malignant skin tumors, vascular anomalies, inflammatory skin conditions, aesthetic procedure complications, and nail pathologies. Ultrasonography offers superior axial spatial resolution compared to imaging modalities like CT or MRI, thanks to technological innovations such as high- and ultra-high-frequency probes reaching up to 70 MHz. These advancements have enhanced the utility of ultrasonography in dermatology, enabling early diagnosis, disease activity tracking, and severity assessment, which collectively improve patient care.
The axial resolution of ultrasonography enables the visualization of submillimeter structures, making it highly effective for precise evaluations. At frequencies like 18 MHz and 70 MHz, ultrasonography achieves resolutions comparable to certain histological analyses. Moreover, guidelines suggest standardizing dermatologic ultrasonography to ensure consistent results, emphasizing the use of high-frequency, color Doppler ultrasound devices. Physicians are recommended to perform a minimum of 300 annual examinations to achieve competency.
Anatomically, ultrasonography
Anatomically, ultrasonography identifies the epidermis as a hyperechoic line, with thicker, bilaminar patterns observed on the palms and soles. The dermis appears as a hyperechoic band, with its echogenicity determined by collagen content. Photoaged skin may show a subepidermal low echogenicity band, distinct from inflammatory signs. The hypodermis, consisting of fatty tissue, appears hypoechoic with hyperechoic fibrous septa between fat lobules.
Dermatologic ultrasonography’s increasing integration into daily clinical practice highlights its potential to revolutionize patient care by enhancing diagnostic accuracy and optimizing treatment strategies for various skin conditions.
