Habib Olapade

Kaposi Sarcoma

Kaposi Sarcoma

Human herpes virus 8 (HHV-8) or Kaposi sarcoma associated herpes virus is the cause of all forms of Kaposi sarcoma. Kaposi sarcoma occurs primarily in homosexual men with HIV infection as an AIDS defining illness and can complicate immunosuppressive therapy. Improvement is often seen after the immunosuppression is stopped. The patient will typically present with red or purple plaques or nodules on cutaneous or mucosal surfaces. Marked edema can occur with few or no skin lesions. Kaposi sarcoma commonly involves the GI tract and can be screened with fecal occult blood testing. In asymptomatic patients, these lesions are not sought or treated. Pulmonary Kaposi sarcoma, which can be asymptomatic and appear only on chest radiography, can present with shortness of breath, cough, hemoptysis, or chest pain. Chronic Kaposi sarcoma can develop in patients with HIV infection, high CD4 counts, and low viral loads. Here, the Kaposi sarcoma is in its endemic form and is indolent as well as localized. The sarcoma can be clinically aggressive, though. The presence of Kaposi sarcoma at the time of antiretroviral initiation is associated with Kaposi sarcoma-immune reconstitution inflammatory syndrome which has an especially aggressive course in patients with visceral disease. As far as treatment is concerned, in more seasoned patients, palliative local therapy with intralesional chemotherapy or radiation is usually all that is required. If the patient has iatrogenic immunosuppression, treatment consists of reduced doses of immunosuppressive medications. On the other hand, if the patient has AIDS associated Kaposi sarcoma, she or he should be given ART. Other therapeutic options include cryotherapy or intralesional vinblastine (0.1-0.5 mg/mL) for cosmetically objectionable lesions; radiation therapy for accessible and space occupying lesions; and laser surgery for certain intraoral and pharyngeal lesions. Systemic therapy is indicated in patients with rapidly progressive skin disease, edema or pain, and symptomatic visceral disease or pulmonary disease. Liposomal doxorubicin is highly effective in severe cases and may be used alone or in combination with bleomycin and vincristine. Paclitaxel and other taxanes can be effective even in patients who do not respond to anthracycline treatment. --- This episode is sponsored by ยท Anchor: The easiest way to make a podcast. https://anchor.fm/app

Duration: 5 min

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