2. First described by Moritz Kaposi in 1872
Most common cutaneous malignancy in HIV
disease
Various visceral organs can also be affected
It has several subtypes which have different
presentations, epidemiology, and prognoses
2
3. Etiopathogenesis
Formed by abnormal proliferation of vascular
endothelial cells
Infection with HHV-8 has been associated
with the development of KS
HHV-8 is found in KS lesional tissue
irrespective of clinical type
Transmission of HHV-8: mainly through
saliva. Organ transplantation, blood
transfusion
3
4. HHV-8 is known to encode products that lead
to growth dysregulation or evasion of immune
surveillance
4
5. Clinical Features
Characterized by brown, pink, red or
violaceous macules/patches,
papules/plaques, nodules
Lesions may vary depending on the clinical
variant
Mucous membrane, cutaneous and visceral
involvement is common (lymph nodes, GIT,
and lungs)
5
9. 1. Classic KS
Indolent disease
Seen chiefly in middle-aged men of southern
and eastern European origin
Early lesions appear most commonly on the
toes or soles as reddish, violaceous, or
bluish-black macules and patches that
spread and coalesce to form nodules or
plaques
9
10. Brawny edema of the affected limb may be
present
Macules or nodules may appear, usually
much later, on the arms and hands, and
rarely may extend to the face, ears, trunk,
genitalia, or oral mucosa
Classic KS has a slowly progressive course
In the early stages of disease, lesions may
undergo spontaneous resolution
10
11. 2. African cutaneous KS
Endemic in tropical Africa
Mostly seen in men between the ages of 20
and 50
It has a locally aggressive but systemically
indolent course
Characterized by nodular, infiltrating,
vascular masses on the extremities
11
12. 3. African lymphadenopathic KS
An aggressive disease of young patients,
mainly children under age 10
Lymph node involvement with or without skin
lesions
Has an aggressive course, often terminating
fatally within 2 years of onset
12
13. 4. AIDS-associated KS
KS in patients immunosuppressed by AIDS
Cutaneous lesions begin as one or several
red to purple-red macules, rapidly
progressing to papules, nodules, and plaques
There is a predilection for the head, neck,
trunk, and mucous membranes
A fulminant, progressive course with nodal
and systemic involvement is expected
13
14. It may be the presenting manifestation of HIV
infection (HIV stage 4)
14
15. 5. Immunosuppression-associated KS
Occurs in patients on immunosuppressive
therapy
Clinical features may be similar to that of
classic KS; however, site of presentation is
more variable
Removal of the immunosuppression may
result in regression of the KS
15
18. Internal involvement
Classic KS: GIT is most frequently involved.
Lungs, heart, liver, conjunctiva, adrenal
glands, abdominal lymph nodes, and bones
may also be affected.
African cutaneous KS: frequently
accompanied by massive leg edema and
frequent bone involvement
African lymphadenopathapic KS:
Reported among Bantu children who develop
massive lymphnode involvement, preceding
appearance of skin lesions
18
19. - The children also develop lesions on the
eyelids and conjunctiva
- Eye involvement is often associated with
swelling of the lacrimal, parotid, and
submandibular glands
AIDS-associated KS: Lungs (37%),
gastrointestinal tract (50%), and lymph nodes
(50%)
19
20. Epidemiology
KS is worldwide in distribution
In africa, it occurs largely in the south of the sahara
Prevalence of AIDS-related KS has decreased due
to widespread availability of HAART
KS associated with other forms of
immunosuppression include those with iatrogenic
suppression from oral prednisone or other chronic
immunosuppressive therapies, as may be given to
transplant patients
It affects more men than women. Ratio ~ 2:1
20
25. Chemotherapy:
- liposomal doxorubicin, liposomal
daunorubicin
- Vincristine, Bleomycin, Doxorubicin: 1st
line at
UTH/CDH
- Paclitaxel monotherapy: 2nd
line agent
25
26. Course
Classic KS: Progresses slowly, rare lymph node or
visceral involvement. Death occurs years later from
unrelated causes
African cutaneous KS: aggressive, early nodal
involvement, death from KS expected within 1-2
years
AIDS-related KS: although widespread, most
patients die of intercurrent infection
Immunosuppression related KS: removal of
immunosuppression may result in resolution of the
KS without therapy
26
