Dermoscopy-guided high-frequency ultrasound: Principles and applications in dermatology

Conventional skin imaging modalities are often bulky, expensive, and impractical for routine dermatology practice. There is a need for a portable, multimodal imaging tool that integrates high-resolution surface and subsurface visualization at the point of care. The aim of this study was to describe the design, technical capabilities, and clinical application of dermoscopy-guided high-frequency ultrasound and to evaluate its performance across a range of dermatologic conditions. Dermoscopy-guided high-frequency ultrasound was applied to a total of 130 lesions from 122 patients at the Department of Dermatology, Semmelweis University (Budapest, Hungary); Université Libre de Bruxelles (Brussels, Belgium); and Hospital Clínic, Universidad de Barcelona (Barcelona, Spain). The examined cases included malignant skin cancers and inflammatory disorders. Dermoscopy-guided high-frequency ultrasound enabled simultaneous visualization and correlation of surface dermoscopic patterns with underlying structural alterations in real time. The device identified disease-specific imaging features for both malignant and inflammatory lesions. Artificial intelligence-based segmentation improved image interpretability. Dermoscopy-guided high-frequency ultrasound bridges a critical gap between surface and subsurface dermatologic imaging, offering a practical, portable, and cost-effective solution that could enhance noninvasive diagnosis and management in dermatologic care.