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Evaluation of 62 pigmented skin tumors of unknown pathology showed that benign and malignant tumors can easily be separated. Benign skin tumors have many internal echoes whereas malignant melanomas show an almost echo-free structure. Superficial spreading melanomas (SSM) and very flat benign tumors were both recorded as thin echogenic layers. It is not possible to differentiate them by US. Real time US is a simple non stressful, reproducible procedure that should be established as a routine diagnostic tool in dermatology.
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