Kaposi’s sarcoma

Published on 05/05/2015 by admin

Filed under Internal Medicine

Last modified 05/05/2015

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180 Kaposi’s sarcoma

Instruction

Look at this skin lesion.

Salient features

History

• Determine whether the patient is immunocompromised (from HIV or from therapy following organ transplantation).

• If the lesion is in the mouth, ask patient whether there is any difficulty in eating (the gingival margin may cause oral hygiene difficult because of secondary infection and pain).

Examination

• Plum-coloured violet plaques, either solitary or in crops, on the limbs, mouth, tip of the nose and palate (Fig. 180.1).

image

Fig. 180.1 Kaposi sarcoma. (A) Violet plaques. (B) Nodules and infiltrated plaques.

Proceed as follows:

• Tell the examiner that you would like to check HIV antibody titres (Kaposi’s sarcoma has an estimated prevalence of 10–20% in HIV-positive patients and was one of the first diseases to define AIDS in 1981).

Diagnosis

This patient has Kaposi’s sarcoma (lesion), which has been shown to be caused by human herpesvirus 8 (aetiology) in patients with AIDS.

Advanced-level questions

What are the varieties of Kaposi’s sarcoma?

• Classic Kaposi’s sarcoma or epidemic type (Fig. 108.1B): initially described in Jews; indolent; found on the legs of elderly men; confined to the skin and may be present for decades; not fatal.

• African variety or endemic type (Fig. 180.2

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