Elastography in Dermatology. / Elastografía en dermatología.

Elastography is a recently developed ultrasound technique applicable to various medical specialties. It provides information on the physical properties of tissues in the context of physiologic and pathologic alterations. In this review we explain the physical principles of the method, the information provided by the different elastography techniques, and its new applications in clinical dermatology.

[Cutaneous ultrasound and dermal fillers]. / Ecografía cutánea y rellenos dermatológicos.

Requests for fillers or dermatological implants have dramatically increased in dermatology consultations in the last few years, either for the correction of superficial age-related wrinkles and cutaneous creases or to increase the volume of specific areas (cheeks, lips...). Dermatologists are often the first professionals to provide these treatments. Nevertheless, in other situations, the patients have already been treated, and many of them do not know the type of material that has been implanted or may even deny previous treatment, even when evident on clinical examination. In these occasions, cutaneous ultrasound is an effective and reliable tool for the real-time diagnosis of the kind of implant that has been used, its location, and the study of its possible complications.

[Ultrasound in the management of inflammatory dermatosis]. / Ecografía aplicada al manejo de las dermatosis inflamatorias.

Cutaneous ultrasound is a dermatological diagnostic imaging technique based on the interaction of high-frequency ultrasounds with the skin. Because it is non-invasive, rapid and accessible, it has increasingly wide clinical applications. This article reviews its use in the management of inflammatory dermatological diseases.

[Ultrasound in the management of benign cutaneous tumours]. / Ecografía aplicada al manejo de tumores cutáneos benignos.

Cutaneous ultrasound carried out by dermatologists is an emerging diagnostic technique that complements the clinical diagnosis of benign cutaneous tumours by providing important information on their structure, their relation to neighbouring structures, and the degree of vascularisation. One of the main key points in the development of this technique for use in cutaneous tumours, which will be discussed in detail, is adequate surgical planning and monitoring of some minor ambulatory surgery techniques, such as drainage or infiltrations. Likewise, cutaneous ultrasound is also useful in the diagnosis of subcutaneous nodules, without clinical/dermoscopic manifestations, and in their differential diagnosis with malignant tumours.

[Ultrasound examination of hidradenitis suppurativa]. / Ecografía de la hidradenitis supurativa.

Hidradenitis suppurativa is a debilitating chronic, recurrent, inflammatory cutaneous disease of the hair follicle that usually presents with painful, deep and inflamed lesions in the areas of the body with apocrine glands, most frequently the axillary, groin and anogenital regions. This entity is difficult to manage since it can be difficult to determine the true nature and extension of the lesions. Cutaneous ultrasound allows real-time visualization of the cutaneous structures under examination, defining the type of lesion, its anatomical extension, and the degree of inflammatory activity, which affects adequate patient management. The present review analyses the importance of ultrasound in the assessment of patients with hidradenitis suppurativa.

[Color Doppler ultrasound of the scalp and hair]. / Ecotomografía Doppler color de cuero cabelludo y pelo.

Color Doppler ultrasound is an imaging technique that allows the study of frequent diseases of the scalp and hair. This examination provides anatomical and functional information in real time that can reveal the extent, activity or severity of common diseases in a non-invasive way, and allows monitoring of their treatment.

The usefulness of high-resolution ultrasound in detecting invasive disease in recurrent basal cell carcinoma after nonsurgical treatment.

INTRODUCTION AND OBJECTIVES: Accurate subtyping of basal cell carcinoma (BCC) is crucial for the effective management of this disease and it is particularly important to distinguish between aggressive and nonaggressive histologic variants. Histologic subtype is not always accurately identified by biopsy and this can have serious implications. High-resolution ultrasound (HRUS) is a recent technique that has proven to be of value in differentiating between variants of BCC. The aim of this study was to investigate the potential usefulness of HRUS for detecting invasive disease in recurrent BCC treated nonsurgically following an initial diagnosis of noninvasive BCC by biopsy. MATERIAL AND METHODS: This was a prospective observational study of consecutive cases of BCC with clinical suspicion of recurrence following nonsurgical treatment and a pretreatment diagnosis of superficial BCC by punch biopsy. Before surgical excision, the recurrent lesions were evaluated by HRUS followed by a punch biopsy of the site of suspected recurrence. The diagnostic agreement between HRUS, punch biopsy, and excisional biopsy was then evaluated. RESULTS: Eight lesions were studied. HRUS identified invasive disease in 3 of the 4 cases that were incorrectly classified as superficial subtypes by punch biopsy. CONCLUSION: HRUS could be useful for detecting persistent tumor after nonsurgical treatment and for choosing the site most likely to harbor invasive disease for punch biopsy.

Ultrasound skin imaging.

The interaction of high-frequency ultrasound waves with the skin provides the basis for noninvasive, fast, and accessible diagnostic imaging. This tool is increasingly used in skin cancer and inflammatory conditions as well as in cosmetic dermatology. This article reviews the basic principles of skin ultrasound and its applications in the different areas of dermatology.

Carcinoma basocelular de la piel cabelluda tratado con HeberFERON. Seguimiento clínico, ecográfico e histopatológico

Fundamento: El carcinoma basocelular es infrecuente en la piel cabelluda. Es un tumor de invasión local y crecimiento lento, puede ser agresivo, destruir tejidos vecinos, causar ulceración e invadir en profundidad cartílago y hueso. Objetivo: Evaluar los resultados de la aplicación del HeberFERON y el seguimiento con ecografía cutánea en pacientes con carcinoma basocelular en la piel cabelluda. Metodología: Se realizó un estudio observacional, descriptivo y longitudinal en una serie de casos con diagnóstico de carcinoma basocelular de la piel cabelluda en el Policlínico Centro de la ciudad Sancti Spíritus, durante el período de 10 de julio del 2018 a 29 de julio del 2022. Se incluyeron 6 casos. Las variables estudiadas fueron la respuesta al tratamiento mediante la clínica, la ecografía cutánea e histopatología y presencia de eventos adversos. Resultados: Predominó el sexo masculino, subtipo histológico sólido, subtipo clínico nódulo ulcerativo, tamaño del tumor mayor de 30 mm y tiempo de evolución de más de 12 meses; la respuesta al tratamiento en la mayoría de los casos fue parcial. Los eventos adversos fueron dolor y ardor en el sitio de inyección, fiebre, edema y eritema perilesional. Conclusiones: El HeberFERON resultó de utilidad en los pacientes con carcinoma basocelular del cuero cabelludo ya que redujo el tumor en unos casos y en otros lo eliminó. La ecografía permitió la evaluación en tiempo real de la neoplasia; los eventos adversos más frecuentes fueron la fiebre y el dolor en el sitio de inyección, a pesar de ello ningún paciente abandonó el tratamiento.

Background: Basal cell carcinoma is uncommon in the scalp. It is a slow-growing locally invasive tumor, it can be aggressive in destroying neighboring tissues, cause ulceration and invade deep into the cartilage and bone. Objective: To evaluate the results of HeberFERON application and follow-up with cutaneous echographical in patients with scalp basal cell carcinoma. Methodology: An observational, descriptive and longitudinal study was conducted in a series of cases diagnosed with scalp basal cell carcinoma at the Center Polyclinic in Sancti Spíritus city during the period from July 10, 2018 to July 29, 2022. Six clinical cases were included. The studied variables were the answer to the treatment by clinical, cutaneous echographical and histopathology and the presence of adverse events. Results: Male sex predominated, solid histologic subtype, clinical subtype ulcerative nodule, tumor size greater than 30 mm and evolution time of over 12 months; the treatment response in most cases was partial; adverse events were pain and burning at the injection site, fever, edema and perilesional erythema. Conclusion: It was observed that in patients with scalp basal cell carcinoma, the HeberFERON treatment reduced in some cases and eliminated the tumor in others. Echography allowed real-time evaluation of the neoplasm, fever and pain at the injection site were the most frequent adverse events. In spite of this, none of the patients abandoned the therapy.

Carcinoma basocelular tratado con HeberFERON, seguimiento clínico, histológico y ecográfico. Reporte de caso / Basal cell carcinoma treated with HeberFERON, clinical, histological and ultrasound follow-up. Case report

RESUMEN Fundamento: El carcinoma basocelular es el cáncer de piel no melanoma más frecuente, es un tumor de invasión local y crecimiento lento, su incidencia está incrementándose y esto requiere métodos diagnósticos y terapéuticos eficaces, accesibles y rápidos. La ecografía cutánea es una técnica diagnóstica no invasiva que utiliza las propiedades físicas del ultrasonido para el estudio de la piel. Objetivo: Describir el caso de una paciente con carcinoma basocelular en borde del pabellón auricular derecho tratado con HeberFERON y seguimiento con ecografía cutánea. Presentación de caso: Paciente femenina de 60 años con carcinoma basocelular en borde del pabellón auricular derecho, al cual se le aplicó tratamiento con HeberFERON con respuesta completa al eliminar el tumor, lo que se comprobó con la clínica, la histopatología y la ecografía cutánea. Conclusiones: La ecografía cutánea permitió visualizar en tiempo real el tamaño y profundidad del tumor en la piel, asimismo fue útil para confirmar la desaparición de la lesión luego del tratamiento con el HeberFERON.

ABSTRACT Background: Basal cell carcinoma is the most frequent non-melanoma skin cancer, it is a locally invasive and slow growing tumor, its incidence is increasing, so requires efficient, accessible and rapid diagnostic and therapeutic methods. Skin ultrasound is a non-invasive diagnostic technique that uses the physical properties of ultrasound to study the skin. Objective: To describe a patient´s case with basal cell carcinoma on the border of the right auricular pavilion treated with HeberFERON and follow-up with skin ultrasound. Case presentation: 60-year-old female patient with basal cell carcinoma on the edge of the right auricular pavilion, treated with HeberFERON with a complete response after eliminating the tumor, it was verified with the clinic, histopathology and skin ultrasound. Conclusions: The skin ultrasound allowed to visualize in real time the size and depth of the skin tumor, it was also useful to confirm the disappearance of the lesion after the treatment with HeberFERON.