Koebner Phenomenon in Kaposi’s Sarcoma: A Large Single-Center Case Series and Review of Current Knowledge

Abstract

Background occasional case reports have described the appearance of Kaposi’s sarcoma (KS) on previously unaffected skin after incidental or accidental injury, but the association is probably under-reported. Objectives to present a large case series of patients suffering from Koebner phenomenon (KP) in KS and describe their main epidemiological, clinical, and therapeutic features. Methods we have retrospectively analyzed our clinical and photographic records of 524 patients who had been diagnosed with KS between 2009 and 2021. Results 31 of 524 (6%) KS patients developed KP. Among these 31 patients, 24 (77%) had KS lesions after surgery, 4 (13%) after electrochemotherapy, laser therapy and cryotherapy, and 3 (10%) on areas affected by bullous diseases. Conclusions trauma, including surgery or other medical procedures, can trigger KS, underlying the importance of treatment options which cause the least injury to the skin.

Multiple Kaposi's sarcoma nodules successfully treated by curettage and vincristine injections in the same session

“…2 Classic surgical treatment of KS nodules is still a common practice for patients with a known history of KS, but should be avoided, as it leads to scarring and increases the risk of recurrence. 2,3 On the other hand, excision of KS nodules by curettage, especially when they are voluminous, exophytic and/or pedunculated, should be preferred as it preserves the surrounding tissue, thus reducing the risk of KS recurrence. 3,4 Additionally, healing by secondary intention reduces the need of medical assistance and results in excellent aesthetic outcomes.…”

“…2,3 On the other hand, excision of KS nodules by curettage, especially when they are voluminous, exophytic and/or pedunculated, should be preferred as it preserves the surrounding tissue, thus reducing the risk of KS recurrence. 3,4 Additionally, healing by secondary intention reduces the need of medical assistance and results in excellent aesthetic outcomes.…”