Disseminated manifestation of Kaposi's Sarcoma in newly diagnosed AIDS in an african female.
BACKGROUND
Kaposi's sarcomas are the most frequent malignancies in patients with AIDS and there is increasing evidence of an association with human Herpesvirus 8 (HHV-8). A reconstitution of the immune response due to different regimens of highly active antiretroviral therapy (HAART) is the most important step in treatment of Kaposi's sarcomas. Local treatment options include the topic application of alitretionin (9-cis-retinoic acid) as a gel, cryotherapy with liquid nitrogen and intralesional vinblastine, as well as local laser or low-dose X-ray treatment. A systemic chemotherapy can be taken under consideration in selected cases with clinical significant visceral lesions or aggressive sarcomatous behavior with anthracyclines, taxanes, as well as an immunomodulatory treatment with alpha Interferon.


METHODS
The case of an african emigrant is described. Hospitalized due to recurrent fever and diarrhea, the diagnosis of AIDS was quickly established. The physical examination revealed multiple nodular, painless skin lesions suspicious of Kaposi's sarcoma. The diagnosis was confirmed histologically, later on also in bronchial and duodenal biopsies due to the atypical subepithelial vessels with slit-like appearance and prominent endothelia.


CONCLUSIONS
Cutaneous lesions in patients with dark skin colour may be unfamiliar to European physicians. In patients with HIV-infection, nodular skin lesions should lead suspicion to Kaposi's sarcoma. If this diagnosis is established, it should be clarified, if other locations (e.g.: intestine, respiratory tract) are involved, too.
Harsch
I A
IA
Department of Medicine I, Friedrich-Alexander University, Erlangen-Nuremberg, Erlangen, Germany.
Kraetsch
H G
HG
Amann
K
K
Hahn
E G
EG
Ficker
J H
JH
Konturek
P C
PC
D015492:AIDS Serodiagnosis; D000163:Acquired Immunodeficiency Syndrome / Q000150:complications* / Q000188:drug therapy; D000328:Adult; D000480:Alkynes; D048588:Benzoxazines; D003521:Cyclopropanes; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D016898:Interferon-alpha / Q000627:therapeutic use; D019259:Lamivudine / Q000008:administration & dosage / Q000627:therapeutic use; D019888:Nelfinavir / Q000008:administration & dosage / Q000627:therapeutic use; D010078:Oxazines / Q000008:administration & dosage / Q000627:therapeutic use; D018894:Reverse Transcriptase Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use; D012514:Sarcoma, Kaposi / Q000150:complications* / Q000188:drug therapy / Q000473:pathology; D018119:Stavudine / Q000008:administration & dosage / Q000627:therapeutic use
D000480:Alkynes; D048588:Benzoxazines; D003521:Cyclopropanes; D016898:Interferon-alpha; D010078:Oxazines; D018894:Reverse Transcriptase Inhibitors; D019259:Lamivudine; D018119:Stavudine; D019888:Nelfinavir; C098320:efavirenz