Primary Palmoplantar Kaposi's Sarcoma: An Unusual Presentation

Abstract

A 65-year-old diabetic Saudi Arabian man taking glibenclamide for 9 years presented with painful reddish patches and plaques involving the palms and soles of 6 months' duration. These lesions started as small faint purple-red macules and gradually increased in number and size. The patient did not seek any medical advice other than for these painful lesions. His medical history was insignificant. On examination, the patient had multiple, discrete, dull red-to-violaceous and tender patches and plaques of variable sizes on both palms and soles (Figure 1 and Figure 2). His mucous membranes, scalp, and nails were normal. A systemic clinical examination was unremarkable other than an amputation of the distal phalanx of the left index. Result of routine laboratory investigations including complete blood cell count, liver and renal function tests, and chest x-ray were normal. An HIV test was negative. A punch skin biopsy taken from the left palm showed acanthosis and spongiosis in the epidermis. The dermis showed a large number of dilated, medium-sized capillaries with scanty extravasated red blood cells, marked infiltration of lymphocytes and histiocytes, and a few plasma cells (Figure 3 and Figure 4). Immunohistochemistry results were positive for CD34 and CD68. Polymerase chain reaction for human herpesvirus 8 was also positive. The treatment options, including cryotherapy and intralesional chemotherapy, were discussed with the patient but, unfortunately, he did not return for follow-up.

Variable clinical presentations of Classic Kaposi Sarcoma in Turkish patients

“…Additionally, CKS itself exhibits a clinical and evolutional heterogenity that this situation is evident with some unusual case reports of CKS in the literature. 1,[9][10][11][12][13][14] As for our patients, the first patient was unusual for morphological presentation of several verrucoid lesions. Although hyperkeratotic-verrucous types were previously mentioned, the lesion was atypical with its horn-like appearance which made us think KS coexistent with squamous cell carcinoma (SCC) or de novo SCC, initially.…”

Oval Brown Plaque on the Palm

“…Palmar involvement has been reported in rare cases, occurring as a solitary, well-demarcated, violaceous macule or patch that may be painful. [10][11][12] Characteristic histopathologic features include a proliferation in the dermis of slitlike vascular spaces and spindle cell proliferation. 13 Treatment options include cryosurgery; pulsed dye laser; and topical, intralesional, or systemic chemotherapy agents, depending on the stage of the patient's disease.…”

A Case of Primary Palmoplantar Kaposi Sarcoma: An Unusual Presentation

“…Clinically, classic KS is a slow-growing tumor that manifests with solitary or multiple plaques and nodules, most frequently localized on the lower legs 2 . Case reports of KS limited to the palms and soles are rare 3 , 4 , and such cases had involved either one palm or one sole only 5 . Our case is of particular interest because both palms and both soles were involved in the same patient.…”