Kaposi's sarcoma overview: Difference between revisions
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==Overview== | ==Overview== | ||
'''Kaposi's sarcoma''' '''(KS)''' is a tumor caused by [[Kaposi's sarcoma-associated herpesvirus|Human herpesvirus 8]] ('''HHV8'''), also known as [[Kaposi's sarcoma-associated herpesvirus]] (KSHV) . | '''Kaposi's sarcoma''' '''(KS)''' is a tumor caused by [[Kaposi's sarcoma-associated herpesvirus|Human herpesvirus 8]] ('''HHV8'''), also known as [[Kaposi's sarcoma-associated herpesvirus]] (KSHV). Kaposi’s sarcoma (KS) is a systemic disease that can present with [[cutaneous]] lesions with or without internal involvement. Four subtypes have been described: Classic KS, affecting middle aged men of Mediterranean and Jewish descent; African endemic KS; KS in [[iatrogenic]]ally [[immunosuppressed]] patients; and AIDS-related KS. The [[erythema]]tous to violaceous cutaneous lesions seen in KS have several morphologies: [[macular]], patch, [[plaque]], [[nodular]], and [[exophytic]]. The cutaneous lesions can be solitary, localized or disseminated. KS can involve the [[oral cavity]], [[lymph node]]s, and [[viscera]]. Classic KS tends to be [[indolent]], presenting with erythematous or violaceous patches on the lower extremities. African [[endemic]] KS and AIDS-related KS tend to be more aggressive. The AIDS-related KS lesions often rapidly progress to plaques and nodules affecting the upper trunk, face, and oral [[mucosa]]. The diagnosis can be made with a tissue [[biopsy]] and, if clinically indicated, internal imaging should be done. | ||
Kaposi’s sarcoma (KS) is a systemic disease that can present with [[cutaneous]] lesions with or without internal involvement. Four subtypes have been described: Classic KS, affecting middle aged men of Mediterranean and Jewish descent; African endemic KS; KS in [[iatrogenic]]ally [[immunosuppressed]] patients; and AIDS-related KS. The [[erythema]]tous to violaceous cutaneous lesions seen in KS have several morphologies: [[macular]], patch, [[plaque]], [[nodular]], and [[exophytic]]. The cutaneous lesions can be solitary, localized or disseminated. KS can involve the [[oral cavity]], [[lymph node]]s, and [[viscera]]. Classic KS tends to be [[indolent]], presenting with erythematous or violaceous patches on the lower extremities. African [[endemic]] KS and AIDS-related KS tend to be more aggressive. The AIDS-related KS lesions often rapidly progress to plaques and nodules affecting the upper trunk, face, and oral [[mucosa]]. The diagnosis can be made with a tissue [[biopsy]] and, if clinically indicated, internal imaging should be done. | |||
Once the diagnosis of KS has been made, treatment is based on the subtype and the presence of localized versus systemic disease. Localized cutaneous disease can be treated with [[cryotherapy]], intralesional injections of [[vinblastine]], [[alitretinoin]] gel, [[radiotherapy]], [[topical]] [[immunotherapy]] ([[imiquimod]]), or surgical [[excision]]. Extensive cutaneous disease and/or internal disease may require IV [[chemotherapy]] and immunotherapy. Discontinuation or reduction of immunosuppressive therapy is recommended when KS arises in the setting of iatrogenic immunosuppression. However, with AIDS-related KS, [[HAART]] has been shown to prevent, or induce [[regression]] of, KS. Some AIDS patients have complete [[resolution]] of the lesions and prolonged remission while continuing the therapy. Therefore, HAART should be considered first-line treatment for these patients, though they may require other concomitant treatments. | Once the diagnosis of KS has been made, treatment is based on the subtype and the presence of localized versus systemic disease. Localized cutaneous disease can be treated with [[cryotherapy]], intralesional injections of [[vinblastine]], [[alitretinoin]] gel, [[radiotherapy]], [[topical]] [[immunotherapy]] ([[imiquimod]]), or surgical [[excision]]. Extensive cutaneous disease and/or internal disease may require IV [[chemotherapy]] and immunotherapy. Discontinuation or reduction of immunosuppressive therapy is recommended when KS arises in the setting of iatrogenic immunosuppression. However, with AIDS-related KS, [[HAART]] has been shown to prevent, or induce [[regression]] of, KS. Some AIDS patients have complete [[resolution]] of the lesions and prolonged remission while continuing the therapy. Therefore, HAART should be considered first-line treatment for these patients, though they may require other concomitant treatments. | ||
Revision as of 14:39, 29 November 2012
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
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Overview
Kaposi's sarcoma (KS) is a tumor caused by Human herpesvirus 8 (HHV8), also known as Kaposi's sarcoma-associated herpesvirus (KSHV). Kaposi’s sarcoma (KS) is a systemic disease that can present with cutaneous lesions with or without internal involvement. Four subtypes have been described: Classic KS, affecting middle aged men of Mediterranean and Jewish descent; African endemic KS; KS in iatrogenically immunosuppressed patients; and AIDS-related KS. The erythematous to violaceous cutaneous lesions seen in KS have several morphologies: macular, patch, plaque, nodular, and exophytic. The cutaneous lesions can be solitary, localized or disseminated. KS can involve the oral cavity, lymph nodes, and viscera. Classic KS tends to be indolent, presenting with erythematous or violaceous patches on the lower extremities. African endemic KS and AIDS-related KS tend to be more aggressive. The AIDS-related KS lesions often rapidly progress to plaques and nodules affecting the upper trunk, face, and oral mucosa. The diagnosis can be made with a tissue biopsy and, if clinically indicated, internal imaging should be done.
Once the diagnosis of KS has been made, treatment is based on the subtype and the presence of localized versus systemic disease. Localized cutaneous disease can be treated with cryotherapy, intralesional injections of vinblastine, alitretinoin gel, radiotherapy, topical immunotherapy (imiquimod), or surgical excision. Extensive cutaneous disease and/or internal disease may require IV chemotherapy and immunotherapy. Discontinuation or reduction of immunosuppressive therapy is recommended when KS arises in the setting of iatrogenic immunosuppression. However, with AIDS-related KS, HAART has been shown to prevent, or induce regression of, KS. Some AIDS patients have complete resolution of the lesions and prolonged remission while continuing the therapy. Therefore, HAART should be considered first-line treatment for these patients, though they may require other concomitant treatments.