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Utility of a High-Resolution Superficial Diagnostic Ultrasound System for Assessing Skin Thickness: A Cross-Sectional Study

Iyengar, Sanjana, MD*; Makin, Inder, R., MD, PhD; Sadhwani, Divya, MD; Moon, Esther, BS*; Yanes, Arianna, F., BA*; Geisler, Amelia, BS*; Silapunt, Sirunya, MD§; Servaes, Sabah, MD; Weil, Alexandra, BS*; Poon, Emily, PhD*; Alam, Murad, MD, MSCI, MBA*,¶,#

doi: 10.1097/DSS.0000000000001445
Original Article

BACKGROUND Compared with other imaging modalities, ultrasound is relatively deeply penetrating and can be used to evaluate deep dermal and subcutaneous structures.

OBJECTIVE Image skin thickness of the face and neck using high-frequency diagnostic ultrasound devices.

MATERIALS AND METHODS Skin overlying 20 different predesignated face and neck anatomic sites in 32 individuals was imaged using 2 commercially available high-frequency diagnostic ultrasound devices, a dedicated imaging device and a diagnostic device bundled with a therapeutic device. At each site, the subcutaneous and combined epidermal and dermal layer thicknesses were assessed by blinded expert raters.

RESULTS Similar skin thickness measurements were obtained. Notably, subcutaneous fat depth was measured to be 0.2 cm at the forehead; 0.5 cm at the mental eminence; and 0.6 cm at the submental, supraglenoid, and temporal regions. The combined epidermal and dermal thickness was approximately 0.1 cm at the zygomatic process, suborbital area, inferior malar region, gonion, supraglenoid area, and nasolabial-buccal, and nasolabial fold regions.

CONCLUSION This is the first study using high-resolution superficial diagnostic ultrasound to map skin thickness of the face and neck at standard anatomic locations. Ultrasound is an inexpensive, noninvasive, and convenient means to monitor dermatologic conditions and guide their treatment.

*Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois;

A.T. Still University School of Osteopathic Medicine in Arizona, Mesa, Arizona;

Department of Dermatology and Cutaneous Surgery, University of South Florida, Tampa, Florida;

§Department of Dermatology, McGovern Medical School at Houston, University of Texas, Houston, Texas;

Department of Radiology, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania;

Departments of Otolaryngology, and

#Surgery, Feinberg School of Medicine, Northwestern University, Chicago, Illinois

Address correspondence and reprint requests to: Murad Alam, MD, Department of Dermatology, 676 N. St. Clair Street, Suite 1600, Chicago, IL 60611, or e-mail: m-alam@northwestern.edu

I.R. Makin is a research adviser to Ulthera-Merz and receives consultation fees for specific tasks. The remaining authors have indicated no significant interest with commercial supporters.

© 2018 by the American Society for Dermatologic Surgery, Inc. Published by Wolters Kluwer Health, Inc. All rights reserved.
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