[The usefulness of high frequency ultrasonography in dermatological practice--ultrasound features of selected cutaneous lesions]. / Zastosowanie ultrasonografii wysokiej czestotliwosci w diagnostyce dermatologicznej--obraz ultrasonograficzny wybranych zmian skórnych.

UNLABELLED: Typical diagnostic process in dermatology includes clinical assessment, dermoscopic and histopathologic examination. Microsonography was initiated in seventies and much progress in the development of high-frequency scanners occurred since that time. The aim of the study was the assessment of high frequency ultrasonography in dermatologic diagnostics. MATERIAL AND METHODS: Examination was performed with 30 MHz ultrasound transducer with 0,1 mm resolution and 7 mm penetration. We examined patients with benign and malignant neoplasms, cicatrical alopecia and morphea. RESULTS: Sonographically, the normal skin is composed of three layers: an epidermal entry echo, dermis and subcutaneous tissue. In healthy skin we can image small hypoechoic areas which correspond to hair folicules, vessels and sebaceous glands. Most of small skin neoplasmatic lesions were hypoechogenic and homogeneous on examination. Extensive lesions were multicomponent with normo-, hypo- and anechogenic structures. The assessment of lesion's boarders allows sometimes to conclude the invasiveness of the lesion. Areas of skin with clinically visible atrophy showed diffuse increasing of echogenicity. In early lesions, without accomplished fibrosis, diffuse decreasing of echogenicity can be observed, that is probably caused by inflammatory infiltration. In comparison to the healthy skin, the ultrasound scan of sclerotic skin shows a wide entry echo and highly reflective, thicker dermis as a result of the collagen fibers accumulation. CONCLUSIONS: Above data suggest that ultrasonographic examination may be a valuable dermatologic diagnostic tool that completes classical dermatologic diagnostics and helps to plan the treatment.

Mycoplasma pneumoniae-induced pneumonia with Stevens-Johnson syndrome of acute atypical course.

We present a case of Stevens-Johnson syndrome of acute clinical course with massive occupation of the mucus membranes of the respiratory system, oral cavity, genitals and conjunctiva in a patient with pneumonia. A probable etiological factor was infection with Mycoplasma pneumoniae, however clarithromycin could be another potential inducing factor.