Although histological assessment can assist in many dermatological diagnoses, there has been a recent trend to add imaging modalities to improve diagnostic accuracy. Ultrasound uses a large array of frequencies that correspond to various depths in the skin: the subcutaneous layer can be viewed with various frequencies in high resolution. Subcutaneous nodules, deep-seated lesions in the deep dermis and subcutaneous layers, are attractive targets for ultrasound imaging because they often show minimal visual changes on the skin surface. The aim of this work is to review the expanding body of literature regarding the use of ultrasound for the visualization of subcutaneous nodules. A review of the literature was conducted with the Covidence review managing using the electronic databases PubMed, Medline (ovid), Web of Science, and Google Scholar with the search terms ‘ultrasound,’ ‘dermatology,’ ‘subcutaneous nodule’, ‘panniculitis,’ ‘sarcoidosis,’ ‘granuloma annular’ and ‘polyarteritis nodosa.’ The search yielded 474 results that were screened. A total of 57 articles were included that were written in English and involved the use of ultrasound for the subcutaneous nodules of human patients. These case reports and case series characterized the sonographic features of the subcutaneous nodules in sarcoidosis (irregular hypoechoic nodule with perilesional hyperechoic portion), granuloma annulare (irregular ill-defined hypoechoic nodule with hyperechoic halo) or panniculitis (septal: hypoechoic thickening of septa between the hyperechoic fatty lobules; lobular: diffuse increase in echogenicity of the fatty lobules). Sonography was shown to be a non-invasive and cost-effective technique to capture images in real-time without ionizing radiation. It can help dermatological diagnoses, direct biopsies, facilitate appropriate treatment, and monitor disease progression. More research is required to understand the full potential of ultrasound for a larger variety of dermatologic concerns.

ESDR159 - Ultrasound to examine subcutaneous nodules in dermatology

The scientific meeting of the European Society for Dermatological Research (ESDR) is held yearly, usually in September. With an international attendance of more than 1000 skin scientists from around the globe, the four-day event includes short oral presentations from peer-reviewed abstracts, keynote lectures from international experts, sponsored symposia, satellite programs, educational events as well as an important focus on posters, networking and building collaborations amongst scientists. For more information about this year’s meeting visit our website.