Nonepidemic Kaposi sarcoma: A recently proposed category

Epidemiology of Kaposi sarcoma: review and description of the nonepidemic variant

“…Patients were followed for a median of 3.5 years (range 0.2–15 years); all patients were alive at that point . The latest case of KS in an HIV‐negative MSM was published in 2017 . In this report, a 55‐year‐old homosexual male presented with KS involving the temple and the lower extremity .…”

“…Its clinical presentation resembles classic KS, with cutaneous involvement, which most commonly occur on the lower limbs but also arms, genitals, and trunk. KS in the HIV‐negative MSM population runs an indolent course similar to classic KS; it is usually chronic, persisting over many years, and presenting as nodules or plaques on the lower extremities . This recently recognized subtype has been termed “nonepidemic KS.”…”

“…Immunohistochemistry for HHV 8 was positive . He was treated conservatively with imiquimod and tretinoin creams with good response and continues to have an indolent course without evidence of HIV …”

“…Most published cases of nonepidemic KS are associated with HHV 8 infection . While HHV 8 seroprevalence is <5% in the general US population, it is markedly elevated in MSM, with estimates ranging from 25 to 60% among HIV‐infected and 20–30% of HIV‐uninfected MSM .…”

“…Beginning in the late 1980s, KS has been sporadically reported in middle-aged HIV-seronegative MSM who have no evidence of immunodeficiency (Table 2). [21][22][23][24][25][26][27][28][29][30][31][32] "Nonepidemic" KS, defined as classic KS arising in middle-aged individuals without AIDS, has also been described in patients from Okinawa, Japan, in the early 1990s, but no mention of sexual activity was noted;…”