High-Frequency Ultrasound Monitoring of Cutaneous Leishmaniasis During Treatment
Treatment of Cutaneous Leishmaniasis: Serial Evaluation by High-Resolution Ultrasonography
This prospective observational cohort study evaluates changes in high-frequency skin ultrasound findings in patients with cutaneous leishmaniasis receiving routine clinical treatment at the University Hospital of Brasilia, Brazil. The primary outcome is clinical cure assessed three months after completion of treatment. Ultrasonography will characterize dermal and hypodermal thickness, echogenicity and color Doppler vascular signals over repeated examinations. Associations of baseline clinical, histopathological, and ultrasound findings with healing will be investigated. Participants will be followed for 12 months from treatment initiation to evaluate their clinical course, including relapse.
Studieoversigt
Status
Status
Betingelser
Betingelser
Intervention / Behandling
Intervention / Behandling
Detaljeret beskrivelse
Patients with cutaneous leishmaniasis will be enrolled consecutively in a prospective, single-center observational cohort at the Leishmaniasis Outpatient Clinic, Dermatology Service, University Hospital of Brasilia (HUB), Brazil. The treating clinicians determine antiparasitic treatment according to routine care; the research protocol does not assign treatment.
The diagnosis will follow an established composite reference standard based on a compatible clinical presentation and parasitological confirmation (for example, direct smear, culture, molecular detection, or amastigotes identified on histopathology), or corroborating non-parasitological findings when parasitological confirmation is unavailable. Histopathological specimens obtained at baseline as part of diagnostic care are available for retrospective review and correlation with clinical and ultrasonographic findings.
Serial high-frequency ultrasound using a Clarius L20 handheld linear scanner (8-20 MHz), including B-mode and color Doppler examination, will assess lesion morphology, echogenicity, dermal and hypodermal thickness, and vascularity. The ultrasound schedule is at days 0, 15, 30, 45, and 90 from initiation of treatment. Clinical follow-up will occur during treatment and for up to 12 months from treatment initiation. No investigational drugs or treatment allocation are part of this observational study.
The primary endpoint is clinical cure at three months following completion of treatment, assessed by clinical examination. Secondary analyses will characterize longitudinal ultrasound changes, the relationship of baseline clinical and histopathological findings with ultrasound features, persistence of sonographic abnormalities at initial clinical cure assessment, and exploratory association of sonographic characteristics with subsequent relapse. Ultrasound findings will not themselves define clinical cure or demonstrate parasite viability.
Undersøgelsestype
Undersøgelsestype
Tilmelding (Anslået)
Tilmelding
Kontakter og lokationer
Studiekontakt
Studiekontakt
- Navn: Daniel Holanda Barroso, PhD
- Telefonnummer: +55 61 3107-3711
- E-mail: danielhbarroso@unb.br
Undersøgelse Kontakt Backup
- Navn: Daniel holanda Barroso, PhD
- Telefonnummer: +5561 3107-3712
- E-mail: daniel.barroso@ebserh.gov.br
Studiesteder
-
-
Federal District
-
Brasília, Federal District, Brasilien
- Rekruttering
- University Hospital of Brasilia - Leishmaniasis Outpatient Clinic
-
-
Deltagelseskriterier
Berettigelseskriterier
Berettigelseskriterier
Aldre berettiget til at studere
- Barn
- Voksen
- Ældre voksen
Tager imod sunde frivillige
Køn, der er berettiget til at studere
Prøveudtagningsmetode
Studiebefolkning
Individuals of any age with confirmed cutaneous leishmaniasis evaluated in the Leishmaniasis Outpatient Clinic at University Hospital of Brasilia, Brazil.
Beskrivelse
Inclusion Criteria:
- Cutaneous lesions clinically compatible with leishmaniasis and diagnosis confirmed according to the study's composite reference standard.
- Evaluation at the Leishmaniasis Outpatient Clinic of the University Hospital of Brasilia.
- Written informed consent from adults or a legally authorized representative's permission and age-appropriate assent for minors, as applicable.
Exclusion Criteria:
- An alternative diagnosis established during diagnostic assessment.
- No confirmed cutaneous leishmaniasis diagnosis.
Additional exclusions, if any, must be verified against the approved study protocol before release.
Studieplan
Hvordan er undersøgelsen tilrettelagt?
Design detaljer
- Observationsmodeller: COHORT
- Tidsperspektiver: PROSPECTIVE
Antal grupper/kohorter
Kohorter og interventioner
Gruppe / kohorteGruppe / kohorte |
Intervention / BehandlingIntervention / Behandling |
|---|---|
|
Patients With Cutaneous Leishmaniasis
Patients with confirmed cutaneous leishmaniasis receiving routine clinical treatment and undergoing repeated clinical and high-frequency ultrasound assessments. |
Serial B-mode and color Doppler skin ultrasonography performed with the Clarius L20 (8-20 MHz) at days 0, 15, 30, 45, and 90 after initiation of clinically indicated treatment. This imaging procedure is for observation and does not determine drug allocation. |
Hvad måler undersøgelsen?
Primære resultatmål
Primære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
|
Proportion of Participants With Clinical Cure
Tidsramme: Three months after completion of routine treatment
|
Percentage of evaluable participants meeting the predefined clinical cure criteria at three months after completion of treatment, based on examination for complete re-epithelialization of ulcerative lesions and resolution or flattening of active inflammatory infiltration. |
Three months after completion of routine treatment
|
Sekundære resultatmål
Sekundære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
|
Longitudinal Change in Dermal Thickness
Tidsramme: Days 0, 15, 30, 45, and 90 after treatment initiation
|
Serial ultrasound measurement of dermal thickness (mm) in the followed cutaneous lesion. |
Days 0, 15, 30, 45, and 90 after treatment initiation
|
|
Longitudinal Change in Sonographic Echogenicity
Tidsramme: Days 0, 15, 30, 45, and 90 after treatment initiation
|
Serial assessment of dermal and hypodermal lesion echogenicity on high-frequency ultrasound. |
Days 0, 15, 30, 45, and 90 after treatment initiation
|
|
Presence of Color Doppler Vascular Signal
Tidsramme: Days 0, 15, 30, 45, and 90 after treatment initiation
|
Presence or absence of detectable color Doppler signal within the studied lesion at each scheduled visit; Doppler settings will be standardized. |
Days 0, 15, 30, 45, and 90 after treatment initiation
|
|
Association Between Baseline Ultrasound and Histopathologic Features
Tidsramme: Baseline, prior to initiation of treatment
|
Exploratory assessment of associations between baseline sonographic morphological features and histopathological findings from the initially sampled lesion. |
Baseline, prior to initiation of treatment
|
|
Residual Ultrasound Abnormalities at Initial Clinical Cure Assessment
Tidsramme: At first documented clinical cure, within 12 months after treatment initiation
|
Presence of persistent sonographic dermal, hypodermal, or vascular abnormalities at the visit when clinical cure is first identified. |
At first documented clinical cure, within 12 months after treatment initiation
|
|
Occurrence of Cutaneous Leishmaniasis Relapse
Tidsramme: Up to 12 months after initiation of treatment
|
Clinical recurrence of cutaneous leishmaniasis after documented initial cure; operational definition of confirmed relapse and at-risk follow-up to be finalized. |
Up to 12 months after initiation of treatment
|
Samarbejdspartnere og efterforskere
Sponsor
Sponsor
Efterforskere
Efterforskere
- Ledende efterforsker: Neysa Aparecida Tinoco Regattieri, Universidade de Brasilia
Datoer for undersøgelser
Studer store datoer
Studiestart (Faktiske)
Studiestart
Primær færdiggørelse (Anslået)
Primær færdiggørelse
Studieafslutning (Anslået)
Studieafslutning
Datoer for studieregistrering
Først indsendt
Først indsendt
Først indsendt, der opfyldte QC-kriterier
Først indsendt, der opfyldte QC-kriterier
Først opslået (Faktiske)
Først opslået
Opdateringer af undersøgelsesjournaler
Sidste opdatering sendt (Faktiske)
Sidste opdatering sendt
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidst verificeret
Sidst verificeret
Mere information
Begreber relateret til denne undersøgelse
Nøgleord
Yderligere relevante MeSH-vilkår
Andre undersøgelses-id-numre
Andre undersøgelses-id-numre
- PB-1838808
- 56214021.6.0000.5558 (Anden identifikator: Plataforma Brasil / CEP-FM-UnB)
Plan for individuelle deltagerdata (IPD)
Planlægger du at dele individuelle deltagerdata (IPD)?
IPD-planbeskrivelse
deidentified study data will be published at dryad repository (https://datadryad.org/) after all publications related to the study are published
IPD-delingstidsramme
after publication of results, one year after conclusion, abril 2029
IPD-delingsadgangskriterier
Publicly evaluable, deidentified data
IPD-deling Understøttende informationstype
- STUDY_PROTOCOL
Lægemiddel- og udstyrsoplysninger, undersøgelsesdokumenter
Studerer et amerikansk FDA-reguleret lægemiddelprodukt
Studerer et amerikansk FDA-reguleret enhedsprodukt
Disse oplysninger blev hentet direkte fra webstedet clinicaltrials.gov uden ændringer. Hvis du har nogen anmodninger om at ændre, fjerne eller opdatere dine undersøgelsesoplysninger, bedes du kontakte register@clinicaltrials.gov. Så snart en ændring er implementeret på clinicaltrials.gov, vil denne også blive opdateret automatisk på vores hjemmeside .