Departments of Dermatology, Venereology, Allergology and Immunology, Dessau Medical Center, Brandenburg Medical School Theodor Fontane, Dessau, Germany,
European Hidradenitis Suppurativa Foundation e.V., Dessau, Germany,
Dermatology. 2019;235(2):144-149. doi: 10.1159/000495982. Epub 2019 Jan 16.
A more reliable classification of skin inflammation and severity of active disease results from ultrasound sonography and the new hidradenitis suppurativa/acne inversa (HS) classification system IHS4. However, an objective assessment of skin inflammation in a continuous mode is still the ultimate goal. Long-wave medical infrared thermography (MIT) may offer a blood flow and temperature differential assessment in inflammatory conditions.
To evaluate the application of MIT in HS.
Standardized photography of the areas involved or been candidates for HS involvement was performed and MIT pictures were taken simultaneously and superimposed on the photographs of 18 patients (11 female, 7 male, median age 38.75 years [95% confidence interval 28.5 and 51 years], Hurley score I 5.6%, Hurley score II 38.9%, and Hurley score III 55.5%). A modification of the Otsu's method facilitated the automatic lesion segmentation from the background, depicting the inflammation area. Moreover, MIT was administered in real-time mode during radical HS surgery.
A 1°C temperature difference from a corresponding symmetric body region was indicative of inflammation. MIT figures detected a gradual increase of skin temperature from 33.0°C in healthy skin on average to 35.0-36.6°C at the center of inflamma tory lesions in the axilla and to 35.4-36.9°C at the center of inflammation in the groin area. Real-time MIT assessment enabled the definition of the margins and depth of the surgical intervention during the procedure.
MIT is a promising tool for the detection of inflammation severity in HS lesions and can be used as a clinical biomarker in evaluation studies of medical and surgical HS treatment.
超声检查和新的化脓性汗腺炎/反向痤疮（HS）分类系统 IHS4 可更可靠地对皮肤炎症和活动性疾病的严重程度进行分类。然而，对皮肤炎症进行连续客观评估仍是最终目标。长波医学红外热成像（MIT）可能为炎症状态下的血流和温差评估提供帮助。
评估 MIT 在 HS 中的应用。
对涉及或可能涉及 HS 的区域进行标准化摄影，并同时拍摄 MIT 图片，并将其叠加到 18 例患者（11 名女性，7 名男性，中位年龄 38.75 岁[95%置信区间 28.5 至 51 岁]，Hurley 评分 I 为 5.6%，Hurley 评分 II 为 38.9%，Hurley 评分 III 为 55.5%）的照片上。Otsu 方法的改进有助于自动从背景中分割病变，描绘出炎症区域。此外，在根治性 HS 手术中实时进行 MIT 检查。
与相应对称身体区域相差 1°C 的温度表明存在炎症。MIT 图像显示，腋窝炎症中心皮肤温度逐渐升高，从健康皮肤的平均 33.0°C 升高至 35.0-36.6°C，腹股沟炎症中心皮肤温度升高至 35.4-36.9°C。实时 MIT 评估使我们能够在手术过程中定义手术干预的边界和深度。
MIT 是一种很有前途的工具，可用于检测 HS 病变中炎症的严重程度，并可作为评估 HS 医学和手术治疗的临床生物标志物。
