title: Infrared thermography to assess proliferation and involution of infantile hemangiomas: a prospective cohort study.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  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.
  
  
  METHODS
  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
  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: Department of Pediatrics, Children's Hospital at London Health Science Centre, University of Western Ontario, London, Ontario, Canada.
authors: Javed Ayoub
authors: JA
authors: Mohammed
authors: Pediatric Dermatology Section, National Children Hospital, San José, Costa Rica.
authors: Alexandra
authors: A
authors: Balma-Mena
authors: Division of Dermatology, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.
authors: Ajith
authors: A
authors: Chakkittakandiyil
authors: Department of General Pathology, McMaster University, Hamilton, Ontario, Canada.
authors: Florentina
authors: F
authors: Matea
authors: Division of Dermatology, Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada.
authors: Elena
authors: E
authors: Pope
mesh_terms: D049109:Cell Proliferation; D015331:Cohort Studies; D005260:Female; D006391:Hemangioma / Q000473:pathology*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007259:Infrared Rays; D008297:Male; D011446:Prospective Studies; D015203:Reproducibility of Results; D012878:Skin Neoplasms / Q000473:pathology*; D013817:Thermography / Q000379:methods