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Speeckaert R, Hoorens I, Lambert J, Speeckaert M, van Geel N. Beyond visual inspection: The value of infrared thermography in skin diseases, a scoping review. J Eur Acad Dermatol Venereol 2024. [PMID: 38251780 DOI: 10.1111/jdv.19796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 11/30/2023] [Indexed: 01/23/2024]
Abstract
Although warmth is a key sign of inflammatory skin lesions, an objective assessment and follow-up of the temperature changes are rarely done in dermatology. The recent availability of accurate, sensitive and cost-effective thermography devices has made the implementation of thermography in clinical settings feasible. The aim of this scoping review is to summarize the evidence around the value and pitfalls of infrared thermography (IRT) when used in the dermatology clinic. A systematic literature search was done for original articles using IRT in skin disorders. The results concerning the potential of IRT for diagnosis, severity staging and monitoring of skin diseases were collected. The data on the sensitivity and specificity of IRT were extracted. Numerous studies have investigated IRT in various skin diseases, revealing its significant value in wound management, skin infections (e.g. cellulitis), vascular abnormalities and deep skin inflammation (e.g. hidradenitis suppurativa). For other dermatological applications such as the interpretation of intradermal and patch allergy testing, hyper-/anhidrosis, erythromelalgia, cold urticaria and lymph node metastases more complex calculations, provocation tests or active cooling procedures are required. Dermatologists should be aware of a learning curve of IRT and recognize factors contributing to false positive and false negative results. Nonetheless, enough evidence is available to recommend IRT as a supplement to the clinical evaluation for the diagnosis, severity and follow-up of several skin diseases.
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Affiliation(s)
| | - Isabelle Hoorens
- Department of Dermatology, Ghent University Hospital, Ghent, Belgium
| | - Jo Lambert
- Department of Dermatology, Ghent University Hospital, Ghent, Belgium
| | | | - Nanja van Geel
- Department of Dermatology, Ghent University Hospital, Ghent, Belgium
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Wortsman X. Key Points to Select a Device for Dermatologic Ultrasound. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2023; 42:521-545. [PMID: 36394307 DOI: 10.1002/jum.16000] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/17/2022] [Accepted: 04/19/2022] [Indexed: 05/26/2023]
Abstract
What points to consider when selecting a device for practicing dermatologic ultrasound is an excellent question. After we met the requisites published in the guidelines for practicing dermatologic ultrasound, it is necessary to consider the main objective of the use because it is not the same to be focused mostly on the avoidance of the puncture of important facial vessels such as the case of injectors of cosmetic fillers in comparison to the use of operators that need to deal with the diagnosis and monitoring of a wide range of dermatologic pathologies. Currently, a broad variety of ultrasound devices meets the minimum requirements for practicing these examinations in the market. Thus, small, portable, and high-end devices may present advantages and limitations that must be balanced according to the primary purposes and the budget. Moreover, the shape and footprint of the probes can make difficult or facilitate a dermatologic procedure. Other points to consider are the type of storage and the need for technical service. In summary, there are key points that we need to consider when we select a dermatologic ultrasound device in dermatology or aesthetics.
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Affiliation(s)
- Ximena Wortsman
- Institute for Diagnostic Imaging and Research of the Skin and Soft Tissues, Santiago, Chile
- Department of Dermatology, Faculty of Medicine, Universidad de Chile, Santiago, Chile
- Department of Dermatology, School of Medicine, Pontificia Universidad Catolica de Chile, Santiago, Chile
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Wortsman X. Aplicaciones frecuentes de la ecotomografía Doppler color en dermatología que permiten ayudar al diagnóstico y manejo. REVISTA MÉDICA CLÍNICA LAS CONDES 2023. [DOI: 10.1016/j.rmclc.2023.02.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023] Open
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Visscher MO, Burkes SA, Adams DM, Hammill AM, Wickett RR. Infant skin maturation: Preliminary outcomes for color and biomechanical properties. Skin Res Technol 2017; 23:545-551. [PMID: 28303612 DOI: 10.1111/srt.12369] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/10/2017] [Indexed: 12/30/2022]
Abstract
BACKGROUND Newborn infant skin changes after birth but studies have focused on the epidermal barrier. Dermal properties are relevant for care, but literature on postnatal changes is sparse. We further characterized skin maturational changes in lightness, color and response to biomechanical stress. METHODS Normal skin sites from subsets of participants in a trial on the progression and stage of infantile hemangiomas were retrospectively examined. Standardized photographs were analyzed as L*, a*, and b* images. Biomechanics were measured with the Cutometer® . RESULTS Color changed significantly with increasing age. Skin was darker and redder at 2.0 vs. 5.4, 8.5 and 12.8 months. Yellow color increased, with higher values at 12.8 vs. 2.0, 3.5 and 5.4 months. Chest tissue was consistently more elastic than arm and face sites, with significantly higher elasticity for the youngest and oldest age groups. Biological elasticity, elastic recovery, and total recovery were significantly greater for the oldest subjects. Viscoelasticity and elastic deformation were lower at 5.5 vs. 8.8 and 17.6 months. Arm viscoelastic creep was highest at 2.8 months. CONCLUSION Skin maturation continues into year two. Increasing elasticity and decreasing viscoelasticity may reflect increased collagen structure/function. The findings have implications for prevention of skin injury associated with mechanical forces.
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Affiliation(s)
- M O Visscher
- Skin Sciences Program, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.,Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - S A Burkes
- Skin Sciences Program, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.,James L. Winkle College of Pharmacy, University of Cincinnati, Cincinnati, OH, USA.,Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - D M Adams
- Hemangioma and Vascular Malformation Center, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.,Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - A M Hammill
- Hemangioma and Vascular Malformation Center, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.,Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - R R Wickett
- James L. Winkle College of Pharmacy, University of Cincinnati, Cincinnati, OH, USA
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Burkes SA, Patel M, Adams DM, Hammill AM, Eaton KP, Randall Wickett R, Visscher MO. Infantile hemangioma status by dynamic infrared thermography: A preliminary study. Int J Dermatol 2016; 55:e522-32. [PMID: 27062495 PMCID: PMC5026852 DOI: 10.1111/ijd.13298] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2015] [Revised: 09/29/2015] [Accepted: 12/28/2015] [Indexed: 12/13/2022]
Abstract
BACKGROUND Infantile hemangiomas (IH) are initially warm due to increased proliferation and perfusion then involute with apoptosis and reduced perfusion. Objective quantitative evaluation of IH treatment response is essential for improving outcomes. We applied a functional imaging method, dynamic infrared (IR) thermography, to investigate IH status versus control skin and over time. MATERIALS AND METHODS A preliminary prospective observational study was conducted among 25 subjects with superficial or mixed IHs (< 19 months) over 59 clinic visits. Infrared images of IHs and control sites, standardized color images, and three-dimensional images were obtained. Tissue responses following application and removal of a cold stress were recorded with video IR thermography. Outcomes included areas under the curve during cooling (AUCcool ) and rewarming (AUCrw ) and thermal intensity distribution maps. RESULTS AUCcool and AUCrw were significantly higher and cooling rate slower for IHs versus uninvolved tissue indicating greater heat, presumably due to greater perfusion and metabolism for the IH. IR distribution maps showed specific areas of high and low temperature. Significant changes in IH thermal activity were reflected in the difference (AUCcool - AUCrw ), with 6.2 at 2.2 months increasing to 37.6 at 12.8 months. IH cooling rate increased with age, indicating slower recovery, and interpreted as reduced proliferation and/or involution. CONCLUSIONS Dynamic IR thermography was a well-tolerated, quantitative functional imaging modality appropriate for the clinic, particularly when structural changes, i.e., height, volume, color, were not readily observed. It may assist in monitoring progress, individualizing treatment, and evaluating therapies. CLINICAL TRIAL REGISTRATION www.clinicaltrials.gov (Identifier NCT02061735).
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Affiliation(s)
- Shoná A Burkes
- Skin Sciences Program, University of Cincinnati, Cincinnati, OH, USA
- James L. Winkle College of Pharmacy, University of Cincinnati, Cincinnati, OH, USA
- Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Manish Patel
- Hemangioma and Vascular Malformation Center, Cincinnati, OH, USA
- Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Denise M Adams
- Hemangioma and Vascular Malformation Center, Cincinnati, OH, USA
- Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Adrienne M Hammill
- Hemangioma and Vascular Malformation Center, Cincinnati, OH, USA
- Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Kenneth P Eaton
- Imaging Research Center, Cincinnati, OH, USA
- Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - R Randall Wickett
- James L. Winkle College of Pharmacy, University of Cincinnati, Cincinnati, OH, USA
| | - Marty O Visscher
- Skin Sciences Program, University of Cincinnati, Cincinnati, OH, USA.
- Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
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Visscher MO, Burkes SA, Adams DM, Gupta A, Wickett RR. Biomechanical properties of infantile hemangiomas: clinical stage and effect of age. Skin Res Technol 2016; 22:487-496. [PMID: 27264201 DOI: 10.1111/srt.12290] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/20/2016] [Indexed: 12/26/2022]
Abstract
BACKGROUND Infantile hemangiomas (IHs) are benign vascular neoplasms with rapid capillary proliferation shortly after birth and slow involution with diminishing capillary proliferative activity, fibrosis, and fatty replacement over 7-10 years. METHODS Hemangiomas and contralateral control sites in 88 subjects were measured using a suction device, 6-mm probe and 200 mbar negative pressure. Mechanical properties were assessed vs. controls and effects of body site, depth, clinical stage, histology diagnosis, and time. RESULTS Biological elasticity, overall elasticity, net elasticity, total recovery, and elastic recovery were lower for IH vs. controls (P < 0.001). IH total deformation, elastic deformation, viscoelastic creep, and residual deformation were higher than controls (P < 0.001). Involuting IHs had lower viscoelasticity than proliferating and stable lesions (P < 0.001) and lower viscoelastic creep than stable IHs (P = 0.04). IH viscoelasticity was higher at 2.3 than 12.9, 23.7, and 61.0 months and at 4.9 and 8.1 than 61.0 months. IH elastic recovery varied by body site with larger differences vs. control for abdomen and leg. Elastic recovery differences from control were smaller at younger vs. older ages. CONCLUSIONS Measurement of biomechanical properties may be useful to characterize IH progression and treatment response in clinical settings.
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Affiliation(s)
- M O Visscher
- Skin Sciences Program, Division of Plastic Surgery, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA. .,Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
| | - S A Burkes
- Skin Sciences Program, Division of Plastic Surgery, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.,Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.,James L. Winkle College of Pharmacy, University of Cincinnati, Cincinnati, OH, USA
| | - D M Adams
- Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.,Hemangioma and Vascular Malformation Center, Cincinnati, OH, USA
| | - A Gupta
- Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.,Hemangioma and Vascular Malformation Center, Cincinnati, OH, USA
| | - R R Wickett
- James L. Winkle College of Pharmacy, University of Cincinnati, Cincinnati, OH, USA
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