CLINICAL PRESENTATION AND NATURAL HISTORY OF AIDS-RELATED KAPOSI'S SARCOMA
Section snippets
CLINICAL FEATURES
AIDS-related KS has a very variable clinical course, ranging from minimal disease, presenting as an incidental finding, to explosive growth resulting in significant morbidity and mortality. The skin lesions can appear anywhere but in some patients are concentrated on the lower extremities, face, and genitalia. The lesions are often elliptic and may be arranged in a linear fashion along skin tension lines; they may also be symmetrically distributed. Early lesions may be difficult to recognize
STAGING AND PROGNOSIS
The initial evaluation of a patient with KS includes a thorough physical examination with special attention to those areas frequently affected by the disease, such as the lower extremities, face, oral mucosa, genitalia, GI tract, and lungs. As previously noted, testing the stool for occult blood is an excellent way to screen for GI lesions. Endoscopy can be reserved for those patients with occult blood or with GI symptoms. In a similar fashion, a chest roentgenogram is an excellent way to
SUMMARY
The clinical course of KS is highly variable, ranging from minimal disease to explosive growth. Extracutaneous spread is common, involving most frequently the oral cavity, GI tract, lungs, and lymph nodes. Both corticosteroid therapy and opportunistic infections are associated with the development of KS and with exacerbation of pre-existing KS in HIV-infected patients. A typical initial evaluation includes a thorough physical examination, fecal occult blood test, chest roentgenogram, and CD4+
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Cited by (59)
Consensus of the Brazilian Society of Infectious Diseases and Brazilian Society of Clinical Oncology on the management and treatment of Kaposi's sarcoma
2014, Brazilian Journal of Infectious DiseasesCitation Excerpt :Pulmonary lesions can be an asymptomatic radiographic finding and pleural effusions are often exudative and hemorrhagic. Lymphadenopathy can be the only manifestation of the disease, which requires a lymph node biopsy and can lead to significant lymphedema.1,17–20 The introduction of HAART in order to control HIV has caused a major change in the behavior of Kaposi's sarcoma related to AIDS: it was accompanied by a dramatic decrease in incidence of disease and its less aggressive presentation, but the disease remains a severe problem in the Western world, as in the case of its manifestation with pulmonary involvement.21,22
A unique herpesviral transcriptional program in KSHV-infected lymphatic endothelial cells leads to mTORC1 activation and rapamycin sensitivity
2013, Cell Host and MicrobeCitation Excerpt :The disease presents as highly vascularized proliferative lesions, typically on the skin, often with accompanying inflammatory changes (Ganem, 2010). KS is an indolent condition in immunocompetent hosts (Brooks, 1986) but is more widespread and aggressive in states of immune deficiency including organ transplantation and AIDS (Dezube, 1996). The principal targets of KSHV infection in KS lesions are elongated spindle cells thought to be of endothelial origin because they express multiple endothelial markers (e.g., CD31, CD34, CD36) (Boshoff et al., 1995; Ensoli et al., 2001).
Purpura and Other Hematovascular Disorders
2013, Consultative Hemostasis and Thrombosis: Third EditionCase 29-2013: A 32-year-old HIV-positive african man with dyspnea and skin lesions
2013, New England Journal of Medicine
Address reprint requests to Bruce J. Dezube, MD, Division of Hematology/Oncology, Beth Israel Hospital, CC 915, 330 Brookline Avenue, Boston, MA 02215
This work was supported by a Career Development Award from the American Cancer Society
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From the Division of Hematology/Oncology, Beth Israel Hospital, Harvard Medical School, Boston, Massachusetts