Sonography of the Skin

  • Stephan El Gammal
  • Claudia El Gammal
  • Peter Altmeyer
  • Michael Vogt


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.


Stratum Corneum Basal Cell Carcinoma Lichen Planus Skin Tumor Papillary Dermis 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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Copyright information

© Springer Berlin Heidelberg 2014

Authors and Affiliations

  • Stephan El Gammal
    • 1
  • Claudia El Gammal
    • 2
  • Peter Altmeyer
    • 3
  • Michael Vogt
    • 4
  1. 1.Department of DermatologyDermatological Clinic, Diakonie Klinikum Bethesda57258Germany
  2. 2.Department of DermatologyMedical Care Center, Diakonie Klinikum Jung-Stilling57072Germany
  3. 3.Dermatological Clinic of the Ruhr-UniversitySt. Josef Hospital44791Germany
  4. 4.Institute for High Frequency TechniquesRuhr-University44780Germany

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