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Sonography of the Skin

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Non Invasive Diagnostic Techniques in Clinical Dermatology

Abstract

Sonography is the oldest noninvasive cross-sectional method to study the skin. Due to technical improvements and advances in signal and image processing in the past 30 years, high-resolution sonography has become a routine diagnostic tool in dermatology.

To study the uppermost skin layers, the axial and lateral resolution was increased significantly. In normal palmar skin, the horny layer is represented as echopoor band below the skin entry echo, traversed by echorich coils, which correspond to eccrine sweat gland ducts. The thickness of this band markedly increases after occlusive application of petrolatum. Its lower border is defined by a thin, echorich line, representing the stratum corneum/stratum Malpighii interface. Underneath, a second echopoor band is visible, which corresponds to the viable epidermis plus the papillary dermis, bordered by the scattered echo reflexes of the reticular dermis. Sonograms of normal glabrous skin show only one echopoor band between the entry echo and the dermal reflexes, corresponding to the viable epidermis plus the papillary dermis. The horny layer cannot be distinguished as a separate structure. Using image analysis and statistical methods on sonograms of skin tumors (malignant melanoma, naecocellurlar nevus, scborhocic keratosis, basal cell carcinoma) and inflammatory diseases (psoriasis, lichen planus) we were able to evaluate the usefullness and the limits of high resolution sonography. Our results show that sonography is a valuable tool for in vivo examination of different normal and pathological skin conditions, ranging from the upper epidermis the to .muscle fascia.

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Author information

Authors and Affiliations

  1. Department of Dermatology, Dermatological Clinic, Diakonie Klinikum Bethesda, Euelsbruchstr. 39, Freudenberg, 57258, Germany

    Stephan El Gammal

  2. Department of Dermatology, Medical Care Center, Diakonie Klinikum Jung-Stilling, Siegen, 57072, Germany

    Claudia El Gammal

  3. Dermatological Clinic of the Ruhr-University, St. Josef Hospital, Bochum, 44791, Germany

    Peter Altmeyer

  4. Institute for High Frequency Techniques, Ruhr-University, Bochum, 44780, Germany

    Michael Vogt

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  1. Stephan El Gammal
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  2. Claudia El Gammal
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  4. Michael Vogt
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Correspondence to Stephan El Gammal .

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Editors and Affiliations

  1. Clinical Dermatology, San Gallicano Dermatological Institute, Rome, Roma, Italy

    Enzo Berardesca

  2. Dermatology, University of California San Francisco, San Francisco, CA, California, USA

    Howard I. Maibach

  3. Proderm, Schenefeld/Hamburg, Germany

    Klaus-Peter Wilhelm

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El Gammal, S., El Gammal, C., Altmeyer, P., Vogt, M. (2014). Sonography of the Skin. In: Berardesca, E., Maibach, H., Wilhelm, KP. (eds) Non Invasive Diagnostic Techniques in Clinical Dermatology. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-32109-2_13

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  • DOI: https://doi.org/10.1007/978-3-642-32109-2_13

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