Kaposi's sarcoma

Kaposi's sarcoma is a multicentric, malignant neoplastic vascular proliferation, characterised by the development of bluish-red nodules on the skin. Sometimes there may be widespread visceral involvement. It may metastasize to lymph nodes.

In the Classical Jewish and Mediterranean variety and the endemic African variety, Kaposi's sarcoma (KS) is an indolent condition with no significant reduction in life expectancy.

• classical KS is a slowly progressive disease affecting Ashkenazi Jews and others of Mediterranean origin
• classical KS affects mainly the lower limbs, although dissemination can occur, particularly in association with immunosuppression.

KS may also occur in immunocompromised patients (e.g. HIV positive patients, transplant patients) and in these patients a particulary virulent, disseminated form occurs

• epidemic KS is related to immunosuppression and is most commonly seen in HIVinfected patients - however is now increasingly reported in immunosuppressed post-transplant patients
• in the early days of the AIDS epidemic up to 40% of patients either presented with KS as their AIDS-defining illness or developed it during the course of the illness
• however since the introduction of highly active antiretroviral therapy (HAART) at an early stage after diagnosis of HIV infection, the incidence of Kaposi?s sarcoma has dropped dramatically to about 10% of the incidence seen 15 years ago. In addition to reducing the incidence of KS, HAART also has a therapeutic effect on established KS, both causing regression of disease and prolonging the disease-free interval

One-third of patients with classical KS require no treatment, but for those patients who require intervention, the same spectrum of treatment modalities as are used in epidemic KS are also active in classical KS

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Reference:

1. NICE (February 2006).CSG Improving Outcomes for People with Skin Tumours including Melanoma: The Manual

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