Kaposi sarcoma: Changing trend in Calabar, south eastern Nigeria

Abstract

Background/objective: Kaposi sarcoma (KS) is now the most frequently reported malignant skin tumour in some areas of Africa and was endemic in Africa before the advent of the human immunodeficiency virus (HIV) infection. The prevalence has increased with the emergence of HIV infection. The objective of this report is to describe the frequency, current clinical pattern, and anatomic distribution of KS in Calabar, south-eastern Nigeria and compare this with total malignant skin tumour. Method: All the patients with histologic diagnosis of KS presenting to the University of Calabar Teaching Hospital from January 2005 and December 2006 were analyzed as part of the wider study of malignant skin tumorus. Diagnosis of HIV was based upon enzyme linked immunosorbent assay. Results: In our study, there were 11 patients (7 males and 4 females), with a male: female ratio of 1.75: 1. This was the commonest malignant skin tumor (38%) followed by squamous cell carcinoma (SCC) (34.5%) and the age ranged from 21 -60 years (mean 42.9years). Nine patients (81.8%) were HIV positive including the 4 females (age ranged from 21 -45 years) and 2(18.2%) HIV negative, aged 59 and 60years. The lower limb was the commonest site (50%). Atypical lesions involved the eyelids/ nose and penis. Conclusion: KS is now the commonest malignant skin tumour in our region with the HIV related KS as the commonest clinical type. Successful prevention and treatment of HIV infection would reduce the prevalence of this tumour.

Endemic (African) Kaposi sarcoma: Presenting as pathological fracture of left tibia and fibula

“…It involves mostly the skin (usual location) especially of the lower extremeties, reported to be predominant site in Africans in keeping with this presentation, [4,8,9]. However, the involvement of bones and skeletal muscles is unusual, hence this communication, [8].…”

“…However, he resides in equatorial Africa an environment endemic for KS. In the authors setting, KS is a common malignancy and ranked second, [3], and in another report, the commonest skin malignancy, [4].…”

“…Classic (Mediterranean), African (Endemic), immunosuppression (transplant) associated and acquired immunodeficiency syndrome (AIDS) associated KS are 4 clinical variants of KS with similar histological features, [3]. Kaposi sarcoma was endemic in Africa prior to the advent of human immunodeficiency virus (HIV), [4]. Clinical presentation as described by Taylor et al (Uganda) may be in the nodular, florid, infiltrating and lymphadenopathy forms, [5].…”

“…In 1914, the first case of KS was described in a West African, and the second was found in Cameroon in 1922, [2]. Classic (Mediterranean), African (Endemic), immunosuppression (transplant) associated and acquired immunodeficiency syndrome (AIDS) associated KS are 4 clinical variants of KS with similar histological features, [3]. Kaposi sarcoma was endemic in Africa prior to the advent of human immunodeficiency virus (HIV), [4].…”

Skin malignancies in Calabar, Southern Nigeria

“…Since the emergence of HIV infection there has been an increase in the prevalence of KS and in Nigeria this has become a major source of morbidity and mortality [19,20]. In our setting, there has been a changing trend with KS (HIVrelated) as the commonest malignancy in our study of skin malignancies in 2005-2006 [21]. In Tanzania [3], it ranked second among skin malignancies.…”