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Melanoma is one of the most unpredictable tumours, as regards both morphology and the course of disease. It may have different clinical forms making it very difficult to diagnose. Therefore, it often surprises even the most experienced dermatologists. Despite numerous attempts, no efficient treatment of advanced stages have been elaborated, and early detection and removal of a skin lesion currently constitutes the most efficient treatment method. Diagnostics uses different types of dermoscopic techniques characterised by considerable sensitivity and specificity in detecting melanoma at an early developmental stage. A continuous development of medical technologies leads to improving many methods of skin lesion imaging. Ultrasonography is one of these methods, enabling evaluation of the thickness of melanoma in vivo with high precision. Change thickness is the decisive factor influencing 5-year survival. The paper evaluates the usefulness of high-frequency ultrasonography (HFUS) in pre-operative melanoma imaging on the basis of literature review. Additionally, the use, role and placement of HFUS in skin melanoma diagnostics is determined.

IntroductionUltrasonographic examination is commonly used in an outpatient setting, possibly due to its low cost, low risk for patients and the possibility to obtain real time images. Typically used heads have the frequency ranging from 7.5 to 12 MHz. Higher frequencies ensure higher resolution, yet they are limited by the penetration depth – reaching from several to several tens of millimetres into the skin. High-frequency ultrasonography (HFUS) appears to be a promising method for the detection and differential diagnostics of selected nodular skin lesions.AimThe study aimed at a comparison of the data obtained by using HFUS, histopathological and dermatoscopic images of selected skin lesions to determine their common features.Material and methodsNodular lesions classified as potentially malignant were subjected to clinical, dermatoscopic and high-frequency ultrasonographic examinations. Then the patients were referred for surgical removal with histopathological assessment.ResultsA total of 54 nodular lesions were examined, out of which 34 were diagnosed as non-melanoma. The most common lesions were melanocytic naevi dermatofibroma, nodular basal cell carcinoma and pyogenic granuloma. Other examined lesions included blue naevus, seborrheic wart, xanthogranuloma juvenile and Spits naevus. In all lesions except Spitz naevus, HFUS images corresponded at least with dermatoscopic or histopathology images.ConclusionsHFUS can be used as a supporting diagnostic tool ensuring better pre-operative proceedings. HFUS is a non-invasive, easy and inexpensive screening method for the determination of different skin cancers as it provides valuable information allowing to determine the cutting margins and lesion shape.

Introduction: There are many papers in the available literature on the pre-operative evaluation of malignant melanoma (MM) using a 20 MHz probe. In many Western European countries, this examination is standard in the diagnosis of such lesions in terms of the resection margin. However, few papers describe and compare the results of melanoma thickness measurements using 20 and 50 MHz frequency probes. Aim: The aim of the study was to evaluate the thickness of melanoma using 20 and 50 MHz probes. In addition, the obtained values were evaluated in comparison to the thickness values obtained in the histopathological examination. Material and methods: Melanoma malignum was confirmed histopathologically in 19 out of 72 patients. Then only those 19 patients were enrolled in the study. Results: A correlation was demonstrated between the thickness of the melanoma measured with the 20 and 50 MHz probes, expressed in mm, and the thickness obtained in the histopathological examination expressed in millimeters (Breslow's scale). It was 0.759 (p < 0.001) and 0.734 (p < 0.001), respectively. The average thickness of melanomas obtained in ultrasound examination was identical for both probes and was 0.74 mm. Conclusions: It seems that both types of probes can be used to assess melanoma thickness. The demonstrated correlation of high-frequency ultrasonography (HFUS) thickness with Breslow's scale indicates that the HFUS evaluation can be used in determination of melanoma resection margins as a repeatable, painless, non-invasive test.

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