Clinic of Dermatology

The Department of Dermatology of the Military Medical Academy is equipped with one of the latest most sophisticated ultrasound technology – High Resolution Ultrasound. Ultrasound is a safe, noninvasive, painless and extremely useful in vivo method for examining and diagnosing many skin diseases.

The ability to observe living tissue at microscopic level stands to introduce a whole new era of clinical investigation and experimental dermatology in the future.

Why to use an Ultrasound?

Dermatology is often referred to as a „visual specialty” wherein a majority of diagnoses can be made by visual inspection of the skin. The physician relies on the anatomic distribution, color, configuration, and visible surface changes of a lesion to make a diagnosis. In some cases, a skin biopsy is performed which again offers the opportunity for a microscopic visual examination of the lesion in question.

There is a clear cut need for an objective noninvasive means of assessing the skin that will supplement the data gathered by the physician, particularly during the conduct of clinical trials of therapeutic agents. Further advances in ultrasound transducer technology may lead to improvements in the assessment of skin disease.

What does ultrasound mean?

The term „ultrasound” refers to sound waves of a frequency that is above the human hearing range. Increasing the frequency improves the resolution, thereby enhancing the ability to discriminate between structures. A greater frequency, however, reduces the depth penetration of the sound wave. In general medical imaging, a frequency of 3,5 – 7,5 MHz is usually used to produce a resolution of 2-3 mm. For skin imaging, a high frequency of 15 MHz and above is used delivering a resolution of 60-120 μm. This is termed High Resolution Ultrasound (HRU).

What are the most common skin diseases and conditions in which ultrasound is applied:

• Hemangiomas: the most common benign vascular tumors. 20 MHz ultrasonography has been used for 3 – dimensional surface contour analysis to evaluate the effectiveness of laser therapy.
• Melanoma – ultrasonography has been used alone and in conjunction with epiluminescence microscopy to evaluate pigmented skin lesions and provide valuable information about the depth and topographic location of skin tumors.
• Defining the exact kind of skin and belonging structures, are especially important in diseases like psoriasis, scleroderma, age related skin changes and skin aging due to excessive sun light exposure.
• Diagnostic differentiation of soft tissue tumors.
• Assessment of lymph nodes reactive to infectious and/or malignant diseases.
• Establishing the exact localization and size of a skin formations – ulcers, area of necrosis, tissue edema, inflammation and follow – up of the healing process and etc.
• Diagnosis of deeper skin structure diseases – cellulites, abscesses, paniculitis, lipomas, fasciitis.

How is it done?

During an ultrasound exam, a sonographer presses a small hand-held device (transducer) against your skin. The transducer generates and receives high frequency sound waves that can not be heard by the human ear.

As a sonographer moves the transducer back and forth over the skin, crystals inside of the transducer emit pulses of sound waves that travel into the body. The tissues, bones and body fluids absorb the sound waves and bounce them back to the transducer. The transducer then sends this information to a computer, which composes detailed images based on the patterns created by the sound waves.