hi it's Dr John Arlette and Calgary Alberta Canada we're going to use our clarius l20 ht3 to look at a skin lesion our patient has had a number of basal cell carcinomas and squamous cell carcinomas and reviewing I noted two lesions ones on the left forehead and the other is in the right conkle bowl and we'll look at these with the ultrasound to see can the ultrasound assist us in identifying the lesion to give us some parameters if we wish to proceed surgically to remove them in these areas and does it add an advantage for us in terms of our patient management both assessment and planning for treatment and then carrying out treatment so we're going to look first at the one on the temple it's this little spot right here you see a little pearly papule we can see he's had a number of actinic keratoses and maybe we'll look at those as well I'm going to put the ultrasound on the area now and we're going to start it up and we're going to go to the Dermatology pattern we're going to do it at one centimeter depth and here's our illusion rate here so let's see what we can see so we see a nodule in the skin and um Let's help ourselves by using our voice control freeze we can see in our image that we have a lesion which is taking up most of the space of the dermis we can see below it we can see some posterior enhancement so that it's probably a little bit cystic we can see the surface of the skin we have a little gel pad we can see the lesion itself is relatively well circumscribed unfreeze and let's just look a little bit closer at that freeze so in looking at our lesion we can see the surface skin is contiguous there's some keratinization freeze and let's look at vascularity color and we can see that the vascularity is really limited to this lesion this is a real advantage of using ultrasound because we can see where the vascularity is let's try and make this a bit bigger turn this a bit to the side this is so cool so we see the vascularity is limited to the lesion that we're examining this has significant implications for us in terms of diagnosing and managing these trees these lesions as well as how we may in the future even do research on how we can approach investigation and diagnosis of cutaneous malignancies to be able to use Imaging to identify a skin lesion that you're suspicious of being a malignancy here we have a way that we can localize changes within the skin in a way that we haven't been able to before that's really in advance
