Document Detail


Kaposi's sarcoma: an update.
MedLine Citation:
PMID:  15334644     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
While there have been many important advances in the study of Kaposi's sarcoma (KS), it remains both a challenge and an enigma in many ways. Kaposi's original description of "multiple idiopathic hemorrhagic sarcoma[s]" in patients who died within 2-3 years resembles KS in AIDS more than classic KS in elderly men of Italian, Jewish, or Mediterranean lineage, in whom the disease is usually benign. KS had been evident in about one-third of those with early AIDS, often as its presenting sign, a pattern markedly reduced in recent times since the introduction of highly active anti-retroviral therapy (HAART). The most important advance has been the convincing etiologic linkage of KS with human herpesvirus 8 (HHV-8), which is necessary but not sufficient. It has a low prevalence in the general population of the USA and UK, with an intermediate rate in Italy and Greece, and a high one in Uganda. KS risk may be significantly lower in AIDS patients with a history of anti-herpes therapy. Many aspects of HHV-8, including its transmission pattern and different genospecies, are being scrutinized. The diagnosis of KS may be difficult. One should be aware of KS clinical variants, including telangiectatic, eccymotic, and keloidal KS. One must consider a number of other disorders, including bacillary angiomatosis. HHV-8 DNA sequences in dermatofibromas and other tumors should probably not be viewed as representing a marker for KS. Therapeutic options vary for KS. Intralesional and low-dose outpatient intravenous vinblastine may be valuable, as immunosuppression with KS is not a good idea if it can be avoided. Anti-herpes virus therapy may have potential for wide use, especially in preventing the development of KS in at risk populations, such as HHV-8 seropositive individuals undergoing transplantation surgery.
Authors:
Robert A Schwartz
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Journal of surgical oncology     Volume:  87     ISSN:  0022-4790     ISO Abbreviation:  J Surg Oncol     Publication Date:  2004 Sep 
Date Detail:
Created Date:  2004-08-30     Completed Date:  2004-09-21     Revised Date:  2005-11-16    
Medline Journal Info:
Nlm Unique ID:  0222643     Medline TA:  J Surg Oncol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  146-51     Citation Subset:  IM    
Copyright Information:
Copyright 2004 Wiley-Liss, Inc.
Affiliation:
Dermatology, New Jersey Medical School, Newark, New Jersey 07103, USA. roschwar@umdnj.edu
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MeSH Terms
Descriptor/Qualifier:
Acquired Immunodeficiency Syndrome / complications*
Anti-HIV Agents / therapeutic use
Anti-Retroviral Agents / therapeutic use
Antiretroviral Therapy, Highly Active*
DNA, Viral
Diagnosis, Differential
HIV Seropositivity
Herpesvirus 8, Human / genetics,  pathogenicity
Humans
Sarcoma, Kaposi* / drug therapy,  epidemiology,  pathology,  prevention & control
Skin Neoplasms / epidemiology,  pathology
Chemical
Reg. No./Substance:
0/Anti-HIV Agents; 0/Anti-Retroviral Agents; 0/DNA, Viral

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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