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Diagnostics
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Ultrasound in the Diagnosis and Management of Skin Diseases
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Ultrasound in the Diagnosis and Management of Skin Diseases

A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Medical Imaging and Theranostics".

Deadline for manuscript submissions: closed (15 December 2024) | Viewed by 9036

Special Issue Editors

Dr. Miklós Gyöngy

E-Mail
Guest Editor
1. Dermus Ltd., Sopron út 64, 1116 Budapest, Hungary
2. Faculty of Information Technology and Bionics, Pázmány Péter Catholic University, Práter utca 50/A, 1083 Budapest, Hungary
Interests: biomedical signal processing; skin lesions; ultrasound
Dr. Norbert Kiss

E-Mail Website
Guest Editor
Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, 1085 Budapest, Hungary
Interests: dermatology; skin cancer; imaging; multiphoton microscopy; high-frequency ultrasound
Special Issues, Collections and Topics in MDPI journals
Dr. Joanna Czajkowska

E-Mail Website
Guest Editor
Faculty of Biomedical Engineering, Silesian University of Technology, Roosevelta 40, 41-800 Zabrze, Poland
Interests: medical image processing and analysis; computer-aided diagnosis; supporting the skin diseases diagnosis; artificial intelligence and machine learning methods
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

High-frequency ultrasound (HFUS) is being given increasing attention as a powerful and accessible tool in the field of dermatology, with the potential to enable non-invasive and efficient diagnosis and management of various skin disorders.

Skin cancer diagnosis and treatment planning, psoriasis therapy monitoring, and the staging of hidradenitis suppurativa are just a few examples—any skin disease extending into the dermis, internal disease with cutaneous involvement, or even wounds or cosmetic complications may be potential applications of HFUS.

This Special Issue is open to receiving publications on any application of ultrasound aiming to diagnose or guide intervention in any medical condition affecting the skin.

Publications involving the use of image processing, computer vision, machine learning, artificial intelligence, or the development and testing of novel ultrasound-based imaging techniques, modalities, or diagnostic/therapeutic protocols are especially welcome.

Dr. Miklós Gyöngy
Dr. Norbert Kiss
Dr. Joanna Czajkowska
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Diagnostics is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

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Published Papers (6 papers)

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Research

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14 pages, 3421 KiB  
Article
Validity and Advantages of Three-Dimensional High-Frequency Ultrasound in Dermatological Evaluation
by Misaki Kinoshita-Ise, Taiichiro Ida, Tatsuro Iwasaki, Hideaki Iwazaki, Kazuyuki Yokota, Hoshito Taguchi and Manabu Ohyama
Diagnostics 2025, 15(2), 223; https://doi.org/10.3390/diagnostics15020223 - 19 Jan 2025
Viewed by 520
Abstract
Background/Objectives: High-frequency ultrasound (HFUS) has been reported to be useful for the diagnosis of cutaneous diseases; however, its two-dimensional nature limits the value both in quantitative and qualitative evaluation. Three-dimensional (3D) visualization might help overcome the weakness of the currently existing HFUS. Methods: [...] Read more.
Background/Objectives: High-frequency ultrasound (HFUS) has been reported to be useful for the diagnosis of cutaneous diseases; however, its two-dimensional nature limits the value both in quantitative and qualitative evaluation. Three-dimensional (3D) visualization might help overcome the weakness of the currently existing HFUS. Methods: 3D-HFUS was newly developed and applied to various skin tumors and inflammatory hair diseases to assess its validity and advantages for dermatological use. Results: Three-dimensional images were successfully obtained from skin tumors, including basal cell carcinoma, subungual squamous cell carcinoma, Bowen’s disease, and malignant melanoma, as well as inflammatory hair loss diseases including alopecia areata in different disease phases and lichen planopilaris. Vertical and horizontal images were generated from the original 3D image data and assessed in comparison with histopathological and/or dermoscopic images. By additionally obtaining horizontal data, lateral tumor margins at any depth were visualized in tumors. In inflammatory hair loss diseases, signs potentially associated with disease activity and pathology were detected. In addition, horizontal evaluation helped grasp hair cycle status and hair follicle densities. Conclusions: These findings suggested that this novel technology holds promise as a robust noninvasive tool to diagnose and evaluate various cutaneous diseases. Full article
(This article belongs to the Special Issue Ultrasound in the Diagnosis and Management of Skin Diseases)
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10 pages, 2662 KiB  
Article
Pitting Is Not Only a Measure of Oedema Presence: Using High-Frequency Ultrasound to Guide Pitting Test Standardisation for Assessment of Lymphoedema
by Jennifer Sanderson, Neil Tuttle, Robyn Box, Hildegard Reul-Hirche and E-Liisa Laakso
Diagnostics 2024, 14(15), 1645; https://doi.org/10.3390/diagnostics14151645 - 30 Jul 2024
Cited by 1 | Viewed by 1034
Abstract
The pitting qualities of lymphoedema tissue change with disease progression. However, little is known about the underlying tissue response to the pitting test or the tissue characteristics that enhance or resist indentation. The pitting test is currently unstandardised, and the influence of test [...] Read more.
The pitting qualities of lymphoedema tissue change with disease progression. However, little is known about the underlying tissue response to the pitting test or the tissue characteristics that enhance or resist indentation. The pitting test is currently unstandardised, and the influence of test technique on pitting outcomes is unknown. Understanding how tissue reacts to applied pressure will build evidence for the standardisation of the pitting test. Ninety pitting test sites from fifteen women with unilateral breast cancer-related lymphoedema were evaluated using high-frequency ultrasound (HFUS), bioelectrical impedance spectroscopy (BIS), and limb volume measures. Three sites on each lymphoedema and non-lymphoedema arm were subject to a 60-s (s) staged pitting test, with changes in tissue features captured with ultrasound imaging before, throughout, and after the pitting test. Pitting qualities of tissues varied greatly, with lymphoedema sites pitting more frequently (p < 0.001) with greater depth (p < 0.001) and requiring a longer recovery time (p = 0.002) than contralateral unaffected tissue. Pitting is not solely attributable to oedema volume. Non-structural and structural characteristics of dermal and subcutaneous layers also influence tissue responses to sustained pressure. To enhance the validity and reliability of pitting assessment, a 60 s staged pitting test with an observation of tissue recovery is recommended for lymphoedema presentations. Full article
(This article belongs to the Special Issue Ultrasound in the Diagnosis and Management of Skin Diseases)
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15 pages, 6723 KiB  
Article
Localised Objective Characterisation Assessment of Lymphoedema (LOCAL): Using High-Frequency Ultrasound, Bioelectrical Impedance Spectroscopy and Volume to Evaluate Superficial Tissue Composition
by Jennifer Sanderson, Neil Tuttle, Robyn Box, Hildegard Reul-Hirche and E-Liisa Laakso
Diagnostics 2024, 14(15), 1616; https://doi.org/10.3390/diagnostics14151616 - 26 Jul 2024
Cited by 1 | Viewed by 969
Abstract
Lymphoedema tissue is characterised by excess free fluid and structural changes to the extracellular matrix (ECM) in the form of fibrotic and fatty deposition. These tissue characteristics are integral to the assessment of lymphoedema progression; however, clinicians and researchers often focus on changes [...] Read more.
Lymphoedema tissue is characterised by excess free fluid and structural changes to the extracellular matrix (ECM) in the form of fibrotic and fatty deposition. These tissue characteristics are integral to the assessment of lymphoedema progression; however, clinicians and researchers often focus on changes in the free fluid, volume and function of lymphatic vasculature to inform practice. Subsequently, little is known about the effect of clinical interventions on lymphoedema tissue composition. This article presents a novel approach to classify lymphoedema tissue. The Localised Objective Characterisation Assessment of Lymphoedema (LOCAL) classification combines diagnostic and clinically meaningful objective assessment thresholds to infer lymphoedema pathophysiological changes in tissue layers. The LOCAL classification method was verified using data from fifteen women with unilateral breast cancer-related lymphoedema who were evaluated at three sites on each arm using high-frequency ultrasound (HFUS), bio-electrical impedance spectroscopy (BIS) and volume measurements. Participants exhibited an uneven distribution of volume between the proximal and distal segments of the arm (p = 0.023), with multiple tissue compositional categories observed across sites on the same limb (p < 0.001). The LOCAL method demonstrated utility in categorising a diverse range of lymphoedema tissue layer changes beyond what can be ascertained from whole-limb measures. Full article
(This article belongs to the Special Issue Ultrasound in the Diagnosis and Management of Skin Diseases)
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16 pages, 8099 KiB  
Guidelines
Best Practices for the Use of High-Frequency Ultrasound to Guide Aesthetic Filler Injections—Part 2: Middle Third of the Face, Nose, and Tear Troughs
by Roberta Vasconcelos-Berg, Stella Desyatnikova, Paula Bonavia, Maria Cristina Chammas, Alexander Navarini and Rosa Sigrist
Diagnostics 2024, 14(22), 2544; https://doi.org/10.3390/diagnostics14222544 - 13 Nov 2024
Cited by 1 | Viewed by 979
Abstract
The midface is a key area in facial aesthetics, highly susceptible to age-related changes such as fat pad absorption, bone resorption, and loss of skin elasticity. These changes lead to the formation of prominent folds, such as the nasolabial fold. In addition, critical [...] Read more.
The midface is a key area in facial aesthetics, highly susceptible to age-related changes such as fat pad absorption, bone resorption, and loss of skin elasticity. These changes lead to the formation of prominent folds, such as the nasolabial fold. In addition, critical vascular structures and non-vascular components, such as the facial artery, angular artery, and parotid gland, make this region prone to complications during filler injections. High-frequency ultrasound (HFUS) offers real-time, radiation-free visualization of facial anatomy, enabling injectors to accurately target the desired treatment planes and avoid critical structures. This article is the second in a series of articles on ultrasound-guided facial injections and focuses on the midface. It provides a detailed overview of the sonographic anatomy of key areas, including the nose, tear trough, nasolabial fold, zygomatic, and preauricular regions. Step-by-step techniques for ultrasound-guided filler injections are described, emphasizing the importance of scanning both before and during injections to ensure safe filler placement. By using ultrasound in this area, injectors can possibly minimize risks such as vascular occlusion and other complications, such as the Tyndall effect and intra-parotid injection. With ongoing advancements, ultrasound-guided injections are expected to become more refined, enhancing both aesthetic outcomes and patient safety. Full article
(This article belongs to the Special Issue Ultrasound in the Diagnosis and Management of Skin Diseases)
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14 pages, 8177 KiB  
Guidelines
Best Practices for the Use of High-Frequency Ultrasound to Guide Aesthetic Filler Injections—Part 1: Upper Third of the Face
by Rosa Sigrist, Stella Desyatnikova, Maria Cristina Chammas and Roberta Vasconcelos-Berg
Diagnostics 2024, 14(16), 1718; https://doi.org/10.3390/diagnostics14161718 - 8 Aug 2024
Cited by 2 | Viewed by 2717
Abstract
Filler injections in the upper face pose significant challenges due to its complex anatomy and proximity to vascular structures. High-frequency Doppler ultrasound offers real-time visualization of facial anatomy, improving both safety and aesthetic outcomes. This paper presents a detailed overview of the ultrasonographic [...] Read more.
Filler injections in the upper face pose significant challenges due to its complex anatomy and proximity to vascular structures. High-frequency Doppler ultrasound offers real-time visualization of facial anatomy, improving both safety and aesthetic outcomes. This paper presents a detailed overview of the ultrasonographic anatomy of the temples, forehead, and glabella, along with reproducible, ultrasound-guided filler injection techniques for these areas. We use two scanning techniques previously described: “scan before injecting” and “scan while injecting”, applicable to subdermal, interfascial, and supraperiosteal planes in the temporal region, as well as the glabella, forehead, and supraorbital region. Ultrasound guidance for filler injections in the upper face can enhance procedural efficacy and safety. By integrating real-time imaging, practitioners can navigate the intricate vascular anatomy more effectively, thereby minimizing the risk of complications. This study highlights the need for ongoing research and continuous education to further refine these techniques and improve patient outcomes. Full article
(This article belongs to the Special Issue Ultrasound in the Diagnosis and Management of Skin Diseases)
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25 pages, 21802 KiB  
Protocol
Development of a Musculoskeletal Ultrasound Protocol to Evaluate Hand Pain in Systemic Sclerosis Patients
by Meridith L. Balbach, Robert Corty, Bradford Hill, Tracy Frech, Fawad Aslam and Erin Y. Chew
Diagnostics 2024, 14(7), 669; https://doi.org/10.3390/diagnostics14070669 - 22 Mar 2024
Cited by 2 | Viewed by 1952
Abstract
Hand impairment is a frequently reported complaint in systemic sclerosis (SSc) patients and a leading cause of disability and diminished quality of life. Managing hand pain can be particularly challenging due to the coexistence of non-inflammatory arthralgias, inflammatory arthritis, acro-osteolysis, tenosynovitis, joint contractures, [...] Read more.
Hand impairment is a frequently reported complaint in systemic sclerosis (SSc) patients and a leading cause of disability and diminished quality of life. Managing hand pain can be particularly challenging due to the coexistence of non-inflammatory arthralgias, inflammatory arthritis, acro-osteolysis, tenosynovitis, joint contractures, tendon friction rubs, nerve entrapment, Raynaud’s phenomenon (RP), digital ulcers (DU), sclerodactyly, calcinosis, and chronic pain. While physical examination and radiographs are the first line methods for evaluating hand pain, they are limited in scope and miss many underlying etiologies of hand impairment. We propose a joint ultrasound (US) hand protocol to differentiate between various articular, periarticular, ischemic, skin, and nerve pathologies and to assist in targeted treatment strategies. Full article
(This article belongs to the Special Issue Ultrasound in the Diagnosis and Management of Skin Diseases)
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