Javed Ayoub Mohammed1, Alexandra Balma-Mena2, Ajith Chakkittakandiyil3, Florentina Matea4, Elena Pope5. 1. Department of Pediatrics, Children's Hospital at London Health Science Centre, University of Western Ontario, London, Ontario, Canada. 2. Pediatric Dermatology Section, National Children Hospital, San José, Costa Rica. 3. Division of Dermatology, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada. 4. Department of General Pathology, McMaster University, Hamilton, Ontario, Canada. 5. Division of Dermatology, Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada.
Abstract
IMPORTANCE: Infantile hemangiomas (IHs) are common benign tumors of infancy that have the potential to interfere with vital organ function and cause permanent disfigurement. Currently, few objective and validated measures exist to assess IHs. OBJECTIVE: To determine the utility of infrared thermography in assessing and monitoring the growth of IHs. DESIGN, SETTING, AND PARTICIPANTS: In a prospective cohort study conducted at an outpatient dermatology clinic of a tertiary care hospital between February 2011 and December 2012, a convenience sample of 42 infants aged 0 to 6 months with an IH were enrolled. The mean age of the study group was 3.7 months, with the majority of IHs being mixed type (57%) affecting the head and neck (81%). Of the infants, 36 (86%) were receiving active treatment during the study period, and patients were followed for a minimum of 3 clinical visits, at least 1 month apart. MAIN OUTCOMES AND MEASURES: Ability of infrared thermography to assess the proliferation and involution of IHs compared with a visual analog scale. Secondary outcomes were reliability, ease of use, and parental acceptance of the instrument. RESULTS: The mean temperature difference at baseline was 1.9°F (95% CI, 1.2°F to 2.7°F), which peaked at 3 months to 2.5°F (95% CI, 0.8°F to 4.2°F), and decreased progressively to 0.2°F (95% CI, -1.1°F to 1.4°F) at 18.5 months (P < .001). This change in temperature was inversely correlated with mean visual analog scale (r = -0.25). Mean temperature differences recorded at baseline and 30 minutes later were not significant (least squares mean baseline temperature, 87.9°F [95% CI, 87.4°F to 88.3°F], vs least squares mean temperature after 30 minutes, 88.1°F [95% CI, 87.7°F to 88.6°F] [P = .14]). Multivariate analysis demonstrated facial location (F(1,365) = 47.63, P < .001), IH type (F(2,365) = 3.26, P = .04), age (F(2,365) = 7.03, P = .001), and surface area at baseline (F(2,365) = 8.18, P < .001) as factors significantly affecting temperature difference over time. Only IH type (Wald χ(22) = 6.79, P = .03) and treatment (Wald χ(21) = 4.29, P = .04) significantly affected time to reach a zero-temperature difference. All caregivers (100%) reported IRT to be easy to implement, quick to perform, and comfortable for their child. CONCLUSIONS AND RELEVANCE: Infrared thermography is a reliable and valid measure of IH growth that is noninvasive, convenient, and well tolerated by infants, making it well suited to daily clinical practice. It has the potential to provide real-time objective results that can be used for routine monitoring and evaluating treatment efficacy.
IMPORTANCE: Infantile hemangiomas (IHs) are common benign tumors of infancy that have the potential to interfere with vital organ function and cause permanent disfigurement. Currently, few objective and validated measures exist to assess IHs. OBJECTIVE: To determine the utility of infrared thermography in assessing and monitoring the growth of IHs. DESIGN, SETTING, AND PARTICIPANTS: In a prospective cohort study conducted at an outpatient dermatology clinic of a tertiary care hospital between February 2011 and December 2012, a convenience sample of 42 infants aged 0 to 6 months with an IH were enrolled. The mean age of the study group was 3.7 months, with the majority of IHs being mixed type (57%) affecting the head and neck (81%). Of the infants, 36 (86%) were receiving active treatment during the study period, and patients were followed for a minimum of 3 clinical visits, at least 1 month apart. MAIN OUTCOMES AND MEASURES: Ability of infrared thermography to assess the proliferation and involution of IHs compared with a visual analog scale. Secondary outcomes were reliability, ease of use, and parental acceptance of the instrument. RESULTS: The mean temperature difference at baseline was 1.9°F (95% CI, 1.2°F to 2.7°F), which peaked at 3 months to 2.5°F (95% CI, 0.8°F to 4.2°F), and decreased progressively to 0.2°F (95% CI, -1.1°F to 1.4°F) at 18.5 months (P < .001). This change in temperature was inversely correlated with mean visual analog scale (r = -0.25). Mean temperature differences recorded at baseline and 30 minutes later were not significant (least squares mean baseline temperature, 87.9°F [95% CI, 87.4°F to 88.3°F], vs least squares mean temperature after 30 minutes, 88.1°F [95% CI, 87.7°F to 88.6°F] [P = .14]). Multivariate analysis demonstrated facial location (F(1,365) = 47.63, P < .001), IH type (F(2,365) = 3.26, P = .04), age (F(2,365) = 7.03, P = .001), and surface area at baseline (F(2,365) = 8.18, P < .001) as factors significantly affecting temperature difference over time. Only IH type (Wald χ(22) = 6.79, P = .03) and treatment (Wald χ(21) = 4.29, P = .04) significantly affected time to reach a zero-temperature difference. All caregivers (100%) reported IRT to be easy to implement, quick to perform, and comfortable for their child. CONCLUSIONS AND RELEVANCE: Infrared thermography is a reliable and valid measure of IH growth that is noninvasive, convenient, and well tolerated by infants, making it well suited to daily clinical practice. It has the potential to provide real-time objective results that can be used for routine monitoring and evaluating treatment efficacy.
Authors: Christopher J Fong; Maria C Garzon; Jennifer W Hoi; Hyun K Kim; Christine T Lauren; Kimberly Morel; Lauren Geller; Nina Antonov; Nicole Weitz; June Wu; Andreas H Hielscher Journal: Pediatr Dermatol Date: 2017-05-26 Impact factor: 1.588
Authors: Shoná A Burkes; Manish Patel; Denise M Adams; Adrienne M Hammill; Kenneth P Eaton; R Randall Wickett; Marty O Visscher Journal: Int J Dermatol Date: 2016-04-08 Impact factor: 2.736