Kaposi's Sarcoma

Diagnosis: Kaposi's Sarcoma

Submitted by Dr. Azeem Alam Khan to dermRounds

Clinical Presentation

Submitted by Dr. Azeem Alam Khan to dermRounds

Clinical History

Violaceous macules, patches, plaques, or nodules. HIV status, immunosuppression history. In classic type: elderly men of Mediterranean/Eastern European descent.

Treatment

HIV-associated: ART initiation. Localized: radiation, intralesional vinblastine, cryotherapy, excision. Systemic: liposomal doxorubicin, paclitaxel, pomalidomide. Iatrogenic: reduce immunosuppression.

Differential Diagnosis

• Bacillary angiomatosis • Pyogenic granuloma • Angiosarcoma • Hemangioma • Dermatofibroma • Melanoma • Stasis dermatitis

Key Learnings

• Caused by HHV-8 (Human Herpesvirus 8) in all variants • Four types: classic (elderly Mediterranean men), endemic (sub-Saharan Africa), iatrogenic (immunosuppression), epidemic (HIV/AIDS) • HIV-associated KS: dramatically decreased with effective ART • Patch → plaque → nodular stage progression • Classic KS: indolent course, lower extremity predominance • Histology: spindle cell proliferation with slit-like vascular channels, PAS+ eosinophilic globules

Tags: kaposi, kodachrome, sarcoma