Hx
May be the presenting manifestation of AIDS.
PE
Widely disseminated papules and plaques
Increased numbers on the trunk and arms
Mucosal surfaces are also involved.
Lesions are barely elevated and vary in color from purple to pink to brown.
Some of the lesions are irritated and have bled profusely. The lesions have been developing over the previous year. The patient thinks he may have also had blood in his urine and in his stool.
Pathophysiology
Endothelial infection with a member of the herpes virus family (herpesvirus type 8).
Lesions that behave like a malignant vascular sarcoma
Formed tumors have spindle cells alternating with slit-like vascular spaces that bleed profusely after minor trauma
AIDS patients very vulnerable to herpes virus infections: herpes simplex I, herpes simplex II, herpes zoster-varicella, cytomegalovirus, and Epstein Bar virus.
Obvious lesions are on the skin, similar lesions in internal organs may cause internal bleeding
An indolent form of Kaposi sarcoma is also rarely seen in older men of Italian or Jewish ancestry who do not have AIDS.
Tx
Kaposi sarcoma has been treated with a variety of chemotherapies; isolated superficial lesions may alternatively respond to electrocoagulation, cryotherapy, and electron beam radiotherapy.
Most patients die of infections secondary to immunosuppression rather than Kaposi sarcoma
