hi I'm Dr John Arlette here in Calgary Alberta today we're going to talk about using ultrasound basically facial Imaging in general Dermatology for changes that you may see on the skin for patients who present with features that they're concerned about it'll help us understand what's going on underneath the skin rather than being able to only interpret what we see on the surface and that normally we would be doing this in the Aesthetics mode for the monitor but we're going to switch this over and we're going to do this on the new Dermatology mode just makes it much easier for us we'll also be using our voice activated and voice controlled software which will help us control the instrument especially useful when we're working alone so we can see here on our on our patient this little change on the cheek and this has been going on for about four months it fluctuates in size you can see that there's a nodule and here to this there's atrophy you can tell that the inflammation's been going on for a while so what we're going to do is just bring our ultrasound device up and we're going to look at the lesion here and we're going to be able to see a number of things that will help us understand it freeze so here we can see our image which shows our cystic lesion inflammation surrounding a central area of material which is reflective so we're seeing some hyperechoic material in the center so we're getting a lot of Reflection from that and that likely represents a keratinous cyst in the middle which we know will not respond to interlesional treatment and so this is a case where we may consider doing a surgical intervention certainly helps us understand what's happening with the patient unfreeze and so we'll just come back to it we can see actually where there's a little Osteo that goes up to the surface of the skin so here with our clarius l20 new HD3 we have great visualization of the lesion which is limited to the dermis we know it doesn't go any deeper than that so that we can have a clear idea when we're going to go in and do our excision how much tissue that we're going to need to remove we've had a really good representation of what this cyst looks like underneath the skin it gives us a better idea of what we're dealing with and lets us be much clearer with our patients rather than saying I think it's this now we can say I'm a much better idea of what's happening and how we can approach treatment it should be really helpful in clinical practice
