Thermal imaging analysis of HS patients using forward-looking infrared technology

Summary: Hidradenitis suppurativa (HS) is a chronic inflammatory skin disorder that affects the folliculopilosebacous unit. HS is associated with upregulation of inflammatory cytokines, suggesting that the cycle of inflammation begins before visible manifestations. Forward-looking infrared (FLIR) imaging offers a non-invasive method to refine surgical resection boundaries by using temperature analysis. This pilot study evaluates the utility of FLIR imaging in mapping affected skin in HS patients to improve surgical outcomes. HS patients undergoing surgical excision were imaged pre- and post-operatively using standard photographs and FLIR imaging after acclimating to operating room temperature. FLIR data identified areas of highest temperature readings, comparing adjacent normal and affected skin to evaluate the accuracy of preoperative surgical markings in resecting diseased tissue while preserving healthy skin. No changes to surgical markings were made based on FLIR analysis. Patients were monitored postoperatively for persistent disease and complications. FLIR imaging of the HS lesion on the left thigh in patient 1 revealed high-temperature areas both within and extending beyond preoperative markings. Post-operative complications included mild wound dehiscence, cellulitis, and an abscess. For patient 2, FLIR imaging of the HS lesions on the right labia revealed high-temperature regions outside surgical borders. Healing was uneventful with no complications or flares observed. This pilot study highlights the potential role of FLIR imaging in enhancing surgical planning for HS patients. The methods used to analyze infrared images provide a framework for future research into thermal mapping to optimize surgical interventions for HS. Seanna Yang¹, Tatjana Mortell¹, Samantha Morin¹, Laurel Adams², Claire Hines¹, Andrea Murina³, Harry Dao⁴, Abigail Chaffin² 1. Tulane University School of Medicine, New Orleans, LA, United States. 2. Department of Surgery, Division of Plastic and Reconstructive Surgery, Tulane University School of Medicine, New Orleans, LA, United States. 3. Department of Dermatology, Tulane University School of Medicine, New Orleans, LA, United States. 4. Department of Dermatology, Loma Linda University School of Medicine, Loma Linda, CA, United States. Clinical Research: Epidemiology and Observational Research