Kaposi’s sarcoma (KS) was first described in the nineteenth century, as a tumor most commonly occur in older middle-aged men of Jewish or Mediterranean. Kaposi’s sarcoma is a malignant neoplasm of spindle cells and vascular elements. More recently, we have seen in Africa, where it is endemic, particularly in East Africa. The lesions in these groups were generally slow growing and responds quickly to treatment. However, in conjunction with HIV infection, the lesions of KS are more aggressive and sometimes quite resistant to therapy.
The causes and course of the disease
The pathogenesis of Kaposi’s sarcoma is unknown. A viral etiology is suggested by epidemiological characteristics. Human immunodeficiency virus (HIV) itself is a co-factor in patients with AIDS, proposed by the induction of Kaposi’s sarcoma.
Kaposi’s sarcoma is made by multifocal, widespread lesions at the onset of the disease. In the first stage or phase of patch, the lesions are small, flat and macula and can red, pink, purple or brown. These lesions may be so inconspicuous that they are easily overlooked. These injuries can affect the skin, mucous membranes, lymph nodes and internal organs, and new lesions in the whole course of the disease. In rare cases, the patient is a single lesion of the skin, often to the head or neck.
Intraoral lesions occur, alone or in combination with the skin, visceral lesions and lymph nodes. Often, the first lesions of Kaposi’s sarcoma appear in the oral cavity. You red, blue or purple and can be flat or raised, single or multiple. The most common site for oral route is reported, the hard palate, although the lesions can be found throughout the oral mucosa, including the gums, soft palate and buccal mucosa. Produce KS lesions on the gums to diffuse swelling of the optic disc, such as periodontitis or sometimes resemble a Parulis. Gingival lesions are associated with significant enlargement of the gums, causing periodontal pocket. The pockets can secondarily infected because of poor oral hygiene, and the mucosal surface can be super-infection with Candida. If the lesions on the tongue, usually in the midline, you can have the lighter color and a number of cases of KS presenting as reported swelling of the mucosa of normal color.
Another unfortunate aspect of Kaposi’s sarcoma is that about one third of patients develop later, a second malignant tumor that usually lymphoma, leukemia or myeloma.
Clinical symptoms:
Like her) to develop, expand and develop into papules or plaques (stage plate. The lesions may expand and phase plate) nodules (nodular stage. The plaque and nodular stage lesions may be red, purple, pink, brown or various combinations of these colors.
In about 26% of homosexual men with AIDS, Kaposi’s sarcoma is present at diagnosis or developed during the course of the disease. In contrast, Kaposi’s sarcoma develops only in about 3% of heterosexual intravenous drug users with AIDS. The incidence of disease is low in people who acquired AIDS through other means.
Differential diagnosis:
The differential diagnosis of patch stage Kaposi’s sarcoma include hemangiomas, venous lakes, purpura, nevi and melanoma. Plaque and nodular stage lesions may be clinically confused with AIDS angiomatosis, hemangioma, pyogenic granuloma, nevi, melanoma, cutaneous lymphoma, and angiosarcoma.
The recommended treatment:
Patients with localized epidemic Kaposi’s sarcoma treated with local arrangements such as surgical excision, electrocautery, curettage or radiotherapy. Treatment of aggressive tumors include radiation therapy, laser surgery and / or the use of chemotherapeutic agents. Radiation therapy is often associated with a rapid onset of severe mucositis, so severe that treatment is often interrupted. The lesions sometimes repeated several months after treatment. Debulking surgery may be successful for small lesions. Patients with disseminated disease can be treated with immunomodulators and single agent or combination chemotherapy for acquired immune deficiency syndrome (AIDS).
