RESUMO
The advances in dermatologic ultrasound have been significantly influenced by the development of high- and ultrahigh-frequency probes, the provision of guidelines for performing the examinations, and a growing number of publications in the field. This review analyzes the most significant contributions that have impacted the daily practice of dermatologists in recent years. This includes the advances in anatomical detection and the patterns of benign and malignant cutaneous tumors, inflammatory dermatologic conditions, vascular anomalies, nail abnormalities, and aesthetic procedures. The knowledge of these advances is a primer for the operators of these examinations.
Assuntos
Neoplasias Cutâneas , Doenças Vasculares , Humanos , Ultrassonografia , Exame FísicoRESUMO
Liposuction is a common aesthetic procedure; however, to date, liposuction has not been linked to morphea. The aim was to review cases with a history of liposuction that presented active morphea lesions in the same surgery regions and were confirmed by ultrasound and histology. A retrospective descriptive analysis of the clinical, ultrasonographic, and pathology database took place (2014-2020). Eleven patients met the criteria. Ultrasound supported the diagnosis, and the ultrasonographic signs of activity in these cases matched the features described in the literature in 100% of cases. In summary, morphea may appear after liposuction and ultrasound can support its early detection.
Assuntos
Lipectomia , Esclerodermia Localizada , Bases de Dados Factuais , Humanos , Lipectomia/efeitos adversos , Lipectomia/métodos , Estudos Retrospectivos , Esclerodermia Localizada/diagnóstico por imagem , UltrassonografiaRESUMO
Cutaneous larva migrans is a common infestation among travelers. Although the diagnosis may be suspected clinically, cases can show atypical presentations. We present the ultrasound features of 4 cases at 18 and 70 MHz. Small linear hyperechoic and hyper-refringent subepidermal and intrafollicular structures suggestive of fragments of larvae, hypoechoic dermal and hypodermal tunnels that match with dilatation of lymphatic ducts, and inflammatory dermal and hypodermal ultrasound signs can support the diagnosis. This work suggests that larvae can penetrate the cutaneous basement membrane through the ostia of the hair follicles and potentially disseminate through the dermal and hypodermal lymphatic network.
Assuntos
Larva Migrans/diagnóstico por imagem , Adulto , Feminino , Humanos , Ultrassonografia/métodosRESUMO
OBJECTIVES: To explore the capability of very high-frequency ultrasound (US; 50-71 MHz) to detect the normal morphologic characteristics of the hair follicles and tracts, sebaceous glands, Montgomery glands, apocrine glands, and arrector pili muscles. METHODS: A retrospective study, approved by the Institutional Review Board, evaluated the normal US morphologic characteristics of the hair and adnexal structures in a database of very high-frequency US images extracted from the perilesional or contralateral healthy skin of 1117 consecutive patients who underwent US examinations for localized lesions of the skin and 10 healthy individuals from December 2017 to June 2018. These images were matched with their counterparts from the database of normal histologic images according to the corporal region. The Cohen concordance test and regional mean diameters of the hair follicles and adnexal structures were analyzed. RESULTS: The normal hair follicles and tracts, sebaceous glands, Montgomery glands, apocrine glands, and arrector pili muscles were observed on US images and matched their histological counterparts in all the corporal regions. There was significant US concordance (κ = 0.82; P = .0001) among observers. Regional mean diameters (millimeters) of the hair follicles, sebaceous glands, and apocrine glands are provided. CONCLUSIONS: The hair follicles and tracts, sebaceous glands, Montgomery glands, apocrine glands, and arrector pili muscles are detectable with very high-frequency US, including some regional and anatomic variants. Knowledge of their normal US appearances is a requisite for detecting subclinical changes, understanding the physiopathologic characteristics, and supporting the early diagnosis and management of common dermatologic diseases.
Assuntos
Glândulas Apócrinas/anatomia & histologia , Folículo Piloso/anatomia & histologia , Glândulas Mamárias Humanas/anatomia & histologia , Músculo Liso/anatomia & histologia , Glândulas Sebáceas/anatomia & histologia , Ultrassonografia/métodos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Adulto JovemRESUMO
Wound healing may be a difficult problem, and variable types of artificial skin prototypes have been developed for supporting this process. Using ultrasound, we studied 4 cellulose-derived artificial skin prototypes and assessed their two-dimensional and three-dimensional morphology. These prototypes were identified on ultrasound both on in vitro and in vivo studies. They allowed the sonographic observation of deeper layers on different types of surfaces of the body with good definition on the in vivo examinations performed on healthy skin and cutaneous ulcers. The ultrasound detection of these artificial biomaterials may potentially support the noninvasive monitoring of wound healing.
Assuntos
Imageamento Tridimensional/métodos , Pele Artificial , Pele/diagnóstico por imagem , Ultrassonografia/métodos , Cicatrização , Feminino , Humanos , Pessoa de Meia-IdadeRESUMO
BACKGROUND: Botulinum toxin type A has been used for treating the hypertrophy of the masseter muscles and its cosmetic effects. Ultrasound is increasingly used in dermatology, along with the guidance of mini-invasive procedures. AIMS: To evaluate the role of ultrasound for guiding the application of Botulinum A toxin in patients with cosmetic alterations due to bruxism, correlate the clinical landmarks with the ultrasound findings, and study the effect on the symptoms, cosmetics, and quality of life. PATIENTS/METHODS: Twenty individuals with bruxism and cosmetic alterations underwent an ultrasound-guided injection of Botulinum toxin type A in each masseter muscle. Clinical and ultrasound marking of the procedure was compared. Clinical and sonographic evaluation was performed at the time of injection and 3 months later. Ten normal individuals underwent ultrasound of the masseter muscles as a control group. RESULTS: Up to 65% of individuals showed anatomical variants of the salivary glands. The method for clinically marking the skin showed a frequently erroneous location of the anterior point (up to 40% of cases) that was proven by ultrasound to be out of the muscle. In 20% of cases, ultrasound showed that the needle should be longer to enter the muscle. After injection, most of the patients demonstrated a decrease of the symptoms and cosmetic and quality of life improvements. CONCLUSIONS: Ultrasound can be a potent tool for guiding the injection of Botulinum toxin into the masseter muscles. It may contribute to a more personalized procedure, better cosmetic results, and help to avoid potential complications.
Assuntos
Pontos de Referência Anatômicos , Toxinas Botulínicas Tipo A/administração & dosagem , Bruxismo/tratamento farmacológico , Músculo Masseter/patologia , Fármacos Neuromusculares/administração & dosagem , Ultrassonografia Doppler , Adulto , Bruxismo/complicações , Estudos de Casos e Controles , Estética , Face/patologia , Feminino , Humanos , Hipertrofia/complicações , Injeções Intramusculares , Masculino , Músculo Masseter/diagnóstico por imagem , Pessoa de Meia-Idade , Estudos Prospectivos , Qualidade de Vida , Ultrassonografia de IntervençãoRESUMO
El uso de la ecografía Doppler color en dermatología ha traspasado la etapa experimental alcanzando la práctica diaria dermatológica. Su utilización abarca una gran variedad de patologías, lo que incluye frecuentes tumores benignos y malignos, enfermedades inflamatorias, el estudio de la uña y el pelo entre muchas otras aplicaciones. Esta técnica por imágenes no invasiva requiere de equipamiento especial y operadores entrenados, estando sus ventajas y limitaciones ya descritas en la literatura. Su utilización también permite discriminar las patologías de origen dermatológico de frecuentes simuladores de enfermedades dermatológicas. La información anatómica detallada descrita por esta técnica no es posible deducir por la mera inspección visual de un clínico, por lo este método por imágenes permitiría ayudar a realizar diagnósticos más precoces y precisos.
The usage of Color Doppler ultrasound in dermatology has surpassed the experimental phase and has been included in the daily dermatologic practice. There is a wide range of applications of this imaging technique such as benign and malignant tumors, inflammatory diseases as well as the study of the nail and the scalp, among others. It requires special ultrasound equipment and trained operators, being their advantages and limitations already described in literature. The detailed anatomical information provided by this imaging technique cannot be deduced by the physical examination of a well-trained physician, therefore this imaging modality may support a more early and precise diagnosis.