A Series of Patients with Kaposi Sarcoma (Mediterranean/Classical Type): Case Presentations and Short Update on Pathogenesis and Treatment

Abstract

BACKGROUND:Kaposi’s sarcoma was first described in 1872 by Moritz Kaposi. To date, it is considered a malignant disease is originating from the endothelial cells of the lymphatic vessels believed to be infected with HHV-8. The current classification defines four major epidemiological forms of Kaposi’s sarcoma: classical, endemic, AIDS-associated, and iatrogenic.CASE REPORT:A 90-year-old male is presented with multiple plaques- and tumour-shaped brown-violet formations located on an erythematous-livid base in the area of both feet and both shanks. Two samples were taken from the lesions on the skin of the shanks, with histopathological examination and the subsequent immunohistochemistry showing Kaposi’s sarcoma.CONCLUSIONS:Kaposi sarcoma is a disease that causes difficulties both in diagnostic and therapeutic respect. The only sure way to determine the correct diagnosis is immunohistochemical staining with the anti-HHV8 antibody. Despite the wide range of systematic and local treatment options, there is still no unified algorithm and a unified strategy for the treatment of Kaposi’s sarcoma.

Iatrogenic Kaposi's sarcoma unmasked by Vedolizumab in a patient with ulcerative colitis and well-controlled human immunodeficiency virus: A case report

“…Although KS can occur at any time, it commonly occurs in patients with HIV with CD4 cells <200 cell/mm 3 , unlike in this patient. [ 4 ] KS developed in this patient, despite not having acquired immunodeficiency syndrome (AIDS), after immunosuppressive therapy to treat his underlying UC suggesting that his KS is iatrogenic. IBD is a chronic inflammation of the gastrointestinal tract and nearly 3 million males and 3.9 million females are living with IBD worldwide.…”

Purple papules during anti‐PD1 immunotherapy for metastatic melanoma

“…Pembrolizumab was not discontinued and did not interfere with the course of the KS. Erika V. De Luca 1,2 , Silvia Catapano 1,2 , Laura Del Regno 1,2 , Alessandro Di Stefani 1,2 , Ketty Peris 1,2 (1) Institute of Dermatology, Università Cattolica del Sacro Cuore, Rome, Italy (2) Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy…”

“…Kaposi sarcoma (KS) is a rare, vascular malignancy which arises in multifocally and is associated with human herpesvirus 8 (HHV8) [1]. Most cases of classic KS are clinically characterized by cutaneous papules and plaques on the lower extremities, and have an indolent clinical course [1]. To our knowledge, this is the first report of KS occurring during anti-PD1 therapy for metastatic melanoma.…”

“…Clinical presentation of KS varies considerably, since lesions may appear as macules, papules, plaques, nodules with or without ulceration, purplish-reddish or brownish in color on the skin or mucosa [1,4]. Dermatoscopy can be useful in diagnosis of KS, showing the structureless polychromatic zone and rainbow pattern that is currently considered to be a highly predictive (albeit not exclusive) feature of the disease [5].…”