High-Resolution Ultrasound as a Key Tool for Dermatologic Surgery

Recent advancements in dermatologic imaging, such as dermoscopy and confocal microscopy, have transformed diagnostic and therapeutic approaches to skin lesions. In this context, high-resolution ultrasound (HRUS) has emerged as a valuable, accessible, and non-invasive modality for real-time visualization of cutaneous structures and skin pathology. Specifically, HRUS enables precise tumor margin delineation, supports biopsy guidance, and helps assess tumor extension, thereby optimizing surgical outcomes and reducing recurrence risk. While technical limitations and the need for operator expertise present challenges, continual technological advancements underscore its growing role in dermatology. This article reviews the applications of HRUS in enhancing surgical precision and outcomes through improved lesion characterization and procedural guidance. It provides a brief introduction to ultrasonography, its anatomical correlation, and representative clinical cases that illustrate its practical utility in dermatologic surgery. This narrative and illustrative review includes selectively chosen references emphasizing clinically relevant, high-impact studies, international consensus guidelines, and key illustrative publications. As high-frequency transducers and new ultrasound methods advance, clinicians will achieve even greater diagnostic and therapeutic precision. Nevertheless, dermatologists must continue to pursue specialized training in ultrasound-guided surgery and adhere to well-established protocols.