Classification

Classic Kaposi sarcoma: This occurs most often in older (> 60 yr). The course is indolent, and the disease is usually confined to a small number of lesions on the skin of the lower extremities; visceral involvement occurs in < 10%. This form is usually not fatal.

AIDS-associated (epidemic) Kaposi sarcoma: This is the most common AIDS-associated malignancy. Multiple cutaneous lesions are typically present, often involving the face and trunk. Mucosal, lymph node, and GI involvement is common.

Endemic Kaposi sarcoma: Prepubertal lymphadenopathic form: It predominantly affects children; primary tumors involve lymph nodes, with or without skin lesions. The course is usually fulminant and fatal.

Adult form: This form resembles classic.

Iatrogenic (immunosuppressive): This typically develops several years after organ transplantation.

Symptoms and Signs

• Cutaneous lesions are asymptomatic purple, pink, or red macules that may coalesce into blue-violet to black plaques and nodules.
• Occasionally, nodules fungate or penetrate soft tissue and invade bone
• Mucosal lesions appear as bluish to violaceous macules, plaques, and tumors

Diagnosis

• Diagnosis is confirmed by punch biopsy
• Patients with AIDS or Immunosuppression require evaluation for visceral spread by CT of the chest and abdomen

Treatment

• Surgical excision, cryotherapy, or electro coagulation for superficial lesions
• Local radiation therapy for multiple lesions or lymph node disease
• Antiretroviral therapy or sometimes IV interferon-α for AIDS-associated Kaposi sarcoma
• Reduction of immunosuppressant for iatrogenic Kaposi sarcoma.