Dr. Otterson presented a very interesting presentation of Kaposi's Sarcoma.
Kaposi's Sarcoma (KS) is an angioproliferative disorder caused by human herpes virus 8 (HHV-8).
There are four variants
Classic- This is seen in patients of Mediterranean descent.
Endemic (sub-Saharan Africa)
Iatrogenic/immunosuppressive
AIDS related- The incidence of KS has decreased dramatically since the inclusion of antiviral therapy for HIV.
Risk factors include:
Immunosuppression from prior malignancy, organ transplant, or HIV/AIDS
Gender (male>female)
Mediterranean descent (for classic Kaposi)
Interestingly, smoking is protective against Kaposi.
Clinically, Kaposi presents as cutaneous and mucocutaneous lesions.
They are classically purple, pink, reddish, or brown in appearance and are more commonly papules but can be macules or plaques.
Lesions develop in the lower extremities classically, but visceral lesions can develop as well.
These typically occur in conjunction with cutaneous lesions.
GI manifestations
Respiratory manifestations- 80-90% of these patients also have mucocutaneous findings. Patients develop dyspnea, dry cough, and hypoxemia. They can develop hemoptysis although this is less common.
Treatment for KS is dependent on the etiology.
For patients with HIV/AIDS, the treatment involves optimizing antiviral therapy.
Local treatment options include radiation, surgery, cryotherapy.
Systemic treatment is also an option and can include liposomal doxorubicin, paclitaxel, or vinblastine.
References
Antman, K and Chang, Y. ”Kaposi’s Sarcoma.” N Engl J Med 2000; 342:1027-1038
Jameson, J et al. ”Harrison’s Principles of Internal Medicine” McGraw Hill. New York. 2018.
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