​Dermatology - Kaposi Sarcoma

​Dermatology - Kaposi Sarcoma

Kaposi sarcoma is a type of tumor that originates from endothelial cells and is associated with infections caused by human herpes virus 8. The four clinical variations include classic, African endemic, immunosuppressive therapy–related, and HIV/AIDS-related.

Typically lacking symptoms, however, individuals experience noticeable cosmetic consequences. Possible symptoms include hemorrhaging or ulceration, and extensive skin lesions might impact functionality. Pain may be experienced in lesions that exhibit tumorous growth, ulceration, or severe edema. Obstructions can be linked to lesions in the urethral or anal canal. Pulmonary Kaposi sarcoma can result in bronchospasm, refractory coughing, dyspnea, and gradual respiratory insufficiency.
Lymphedema typically manifests in the lower extremities and arises from the merging of lesions caused by the deeper infiltration of lymphatics and lymph nodes. Initially, distal edema may affect only one side, but eventually it becomes symmetrical and involves the lower legs, genitalia, and/or face.

Kaposi sarcoma typically initiates as a bruise-like spot that progresses into patches, raised areas, large flat lesions, solid masses, and tumors. These growths can appear violet, red, pink, or tan, and darken to a purple-brown shade with a greenish ring of hemosiderin as they mature. The majority of lesions are detectable by touch, exhibiting a firm to hard texture, even during the early stages of development. Initially, they frequently have an oval shape and are commonly aligned parallel to the tension lines of the skin on the trunk. Lesions typically develop at areas of physical injury, particularly in the extremities. Over time, separate sores may become larger and merge together, creating tumor masses. Additional modifications to larger nodules and tumors encompass erosion, ulceration, crusting, and hyperkeratosis.

The diagnosis is established with a clinical examination and subsequent skin biopsy. The differential diagnosis comprises many single pigmented lesions, such as dermatofibroma, pyogenic granuloma, hemangioma, bacillary (epithelioid) angiomatosis, melanocytic nevus, ecchymosis, granuloma annulare, insect bite reactions, and stasis dermatitis.

The objective of therapy is to manage symptoms, and many local and systemic therapeutic approaches have proven to be beneficial. These include radiotherapy targeted at affected areas, chemotherapy, cessation of any immunosuppressive medications, and administration of antiretroviral agents in the presence of HIV.