Guidelines for Performing Dermatologic Ultrasound Examinations by the DERMUS Group

High variable-frequency ultrasound is a recently available technique capable of clearly defining skin layers and deeper structures that also provides local perfusion patterns obtained in real time. The aim of the study was to assess the performance of variable-frequency ultrasound in the evaluation of skin lesions. We performed a retrospective study of 4338 skin ultrasound examinations in predominantly localized skin lesions, and in a group of 130 healthy controls. We determined ultrasound sensitivity, specificity, and statistical level of certainty, and compared ultrasound diagnoses with clinical diagnoses. Referring diagnosis was correct in 73% of the lesions, and addition of ultrasound increased correctness to 97% (P < .001 for the difference). Ultrasound overall sensitivity was 99%, specificity was 100%, and statistical diagnostic certainty was 99% Ultrasound in its current version cannot detect lesions that are epidermal only or that measure less than 0.1 mm in depth. Ultrasound is a reliable adjuvant for the accurate and precise diagnosis of skin lesions. Copyright (c) 2009 American Academy of Dermatology, Inc. Published by Mosby, Inc. All rights reserved.

Ultrasonic imaging has been used in the field of dermatology for nearly 30 years. In this review, we seek to explain the basic principles of ultrasound as they relate to the skin. Based on differences in keratin, collagen, and water content, ultrasonic waves are reflected back to a transducer and translated into a gray-scale image for interpretation. The technicalities of the process and its variations (power, continuous wave Doppler ultrasound, ultrasound elastography) are briefly reviewed, and we further highlight many of the applications for ultrasound in the treatment and diagnosis of dermatologic conditions, including melanoma and nonmelanoma skin cancer, benign tumors, inflammatory diseases, and lipoablation. Each of these entities is uniquely characterized using ultrasonic techniques. Based on published sources, we contend that although ultrasound is still being fine-tuned for application in dermatology and largely remains in experimental phases, it has potential for use in many arenas of our specialty. Copyright © 2011 American Academy of Dermatology, Inc. Published by Mosby, Inc. All rights reserved.

In recent years, there has been growing use of sonography in the dermatologic field. Thus, this review analyzes the most common dermatologic applications of sonography with some technical considerations for performing this type of examination. Moreover, the sonographic findings in common benign and malignant skin tumors, inflammatory dermatologic diseases, and ungual and cosmetic conditions, among others, are considered. Thus, this noninvasive technique may be a potent adjunctive tool in the diagnosis and management of dermatologic conditions in daily practice, delivering critical information otherwise unavailable to the clinical naked eye.