Diagnosis: Kaposi's sarcoma
cover page of MMWR of July 3, 1981. Considered to be the first major public info regarding (what later became known as) AIDS. Clinical photograph sourced from Wikimedia Commons (Public domain). Attribution: US gov't.
Violaceous to dark brown-black macules, papules, plaques, and nodules. May follow Langer's lines. Can involve skin, oral mucosa, lymph nodes, and viscera (GI, lungs). AIDS-associated KS often widespread and rapidly progressive.
Classic: elderly men of Mediterranean/Eastern European descent. AIDS-associated: declining with antiretroviral therapy. Iatrogenic: organ transplant recipients. HHV-8 seroprevalence varies geographically. Check HIV status in all patients with KS.
AIDS-KS: antiretroviral therapy (immune reconstitution). Localized: radiation, cryotherapy, intralesional vinblastine, topical alitretinoin. Widespread/visceral: liposomal doxorubicin, paclitaxel, immunotherapy (pembrolizumab). Iatrogenic: reduce immunosuppression.
Bacillary angiomatosis, Angiosarcoma, Pyogenic granuloma, Dermatofibroma, Melanoma, Stasis dermatitis
Initiation of ART may cause KS-IRIS (immune reconstitution inflammatory syndrome) with paradoxical worsening. Bacillary angiomatosis (Bartonella) can mimic KS in HIV patients — biopsy essential. HHV-8 serology helps confirm diagnosis.
Tags: Kaposi sarcoma, HHV-8, vascular, neoplasm, AIDS-related