KAPOSI’S SARCOMA

The incidence of Kaposi’s sarcoma (KS) has increased dramatically with
the current HIV epidemic. Although cases of classic (endemic) KS still
occur, the vast majority we see today is HIV-related. KS, which has now
been related to the oncogenic Human Herpes Virus-8, is a tumour of the
cells of the vascular wall of blood and lymph vessels. Classic KS
presents as purple-black papules and plaques usually on one leg which
progress very slowly or remain stationary, even over 20 years or more.
HIV related KS progresses much faster and more aggressively.
HIV-related KS often presents with generalised lymph node
enlargement or pleural lesions. Purple-black nodules and plaques appear
on the face, the trunk, the genitalia or the proximal limbs, especially the
thighs. Lesions may also be warty, tumorous, may ulcerate and they may
cause gross oedema, especially in the face and of the penis and scrotum.
Infiltration of the skin makes it "as hard as wood" on palpation. Plaques,
nodules and tumours in the mouth, especially on the hard palate and
tonsils are very common, always examine the mouth of a suspected KS
patient.
Management of Kaposi’s sarcoma
Treatment options depend on extent of tumor and growth rate, HIV viral load, and
general condition of the patient. Limited skin disease may be treated with cryotherapy,
or intralesional vinblastine or vincristine or radiation therapy. The extensively affected
patient will need referral for radiotherapy or chemotherapy