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The imaging of changes to the skin, the subcutis and especially the regional lymph nodes by high-resolution ultrasound is an integral part of routine dermatological diagnostics. This is mainly done with electronic scanners operating at frequencies between 7.5 and 20 MHz (conventional ultrasound diagnostics). In addition, there are very high-frequency ultrasound systems (frequencies up to 100 MHz) that are used for special scientific questions. Ultrasound diagnostics has a number of advantages over other cross-sectional imaging techniques but is more dependent than these on the individual experience of the examiner. Structured training and continuing education are therefore essential for ultrasound diagnostics, also in dermatology. The following overview describes the most important indications for conventional sonography in dermatology in addition to the physical, technical and administrative principles.Die Darstellung von Veränderungen der Haut, der Subkutis und v. a. der regionären Lymphknoten mithilfe des hochauflösenden Ultraschalls ist fester Bestandteil der dermatologischen Routinediagnostik. Diese erfolgt überwiegend mithilfe elektronischer Scanner, die mit Frequenzen zwischen 7,5 und 20 MHz arbeiten (konventionelle Ultraschalldiagnostik). Daneben existieren sehr hochfrequente Ultraschallsysteme (bis 100 MHz), die eher für spezielle wissenschaftliche Fragestellungen verwendet werden. Die Ultraschalldiagnostik weist gegenüber anderen Schnittbildverfahren eine Reihe von Vorteilen auf, ist aber mehr als diese von der individuellen Erfahrung des Untersuchers abhängig. Strukturierte Aus‑, Weiter- und ständige Fortbildung sind für die Ultraschalldiagnostik, auch in der Dermatologie, unerlässlich. Der vorliegende Beitrag beschreibt die physikalisch-gerätetechnischen und administrativen Grundlagen sowie die wichtigsten Indikationen zur konventionellen Sonographie in der Dermatologie.

Ultrasonography is an essential tool for most medical specialties; training in its use is required for dermatology residency programs in Germany. Ultrasonography is a versatile, painless, low-risk, non-invasive procedure which can be done anywhere and easily repeated; it provides real-time visual information about benign and malignant processes in the skin and subcutis. High frequency sonography with 20 MHz scanners is well-established for measuring the thickness of the skin or its tumors and assessing inflammatory skin disorders. Mid-frequency sonography with 7.5-15 MHz sounds is widely used in dermatologic oncology, both for pre-operative staging and follow-up of melanoma patients. The interpretation of sonographic images such as borders of lesions, echogenicity, artifacts and vascular patterns with duplex color sonography requires structured education and intensive training. The wide variety of diagnostic information provided by sonography underlines its essential position in certified skin cancer centers.