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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Article Home Skin Disorders Kaposi's sarcoma

Kaposi's sarcoma

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Kaposi's sarcoma is a multicentric vascular tumor caused by herpesvirus type 8. It can occur in classic, AIDS-associated, endemic, and iatrogenic forms. The tumor cells have a spindle shape, resembling smooth muscle cells, fibroblasts, and myofibroblasts.

Classification

Classic Kaposi sarcoma: This occurs most often in older (> 60 yr). The course is indolent, and the disease is usually confined to a small number of lesions on the skin of the lower extremities; visceral involvement occurs in < 10%. This form is usually not fatal.


AIDS-associated (epidemic) Kaposi sarcoma: This is the most common AIDS-associated malignancy. Multiple cutaneous lesions are typically present, often involving the face and trunk. Mucosal, lymph node, and GI involvement is common.


Endemic Kaposi sarcoma: Prepubertal lymphadenopathic form: It predominantly affects children; primary tumors involve lymph nodes, with or without skin lesions. The course is usually fulminant and fatal.


Adult form: This form resembles classic.


Iatrogenic (immunosuppressive): This typically develops several years after organ transplantation.

Symptoms and Signs

  • Cutaneous lesions are asymptomatic purple, pink, or red macules that may coalesce into blue-violet to black plaques and nodules.
  • Occasionally, nodules fungate or penetrate soft tissue and invade bone
  • Mucosal lesions appear as bluish to violaceous macules, plaques, and tumors

Diagnosis

  • Diagnosis is confirmed by punch biopsy
  • Patients with AIDS or Immunosuppression require evaluation for visceral spread by CT of the chest and abdomen

Treatment

  • Surgical excision, cryotherapy, or electro coagulation for superficial lesions
  • Local radiation therapy for multiple lesions or lymph node disease
  • Antiretroviral therapy or sometimes IV interferon-α for AIDS-associated Kaposi sarcoma
  • Reduction of immunosuppressant for iatrogenic Kaposi sarcoma.