Kaposi's Sarcoma

Tania J. Phillips, MD, FRCPC

Disclosures

Wounds. 2001;13(6) 

In This Article

Patient Management

Classic Kaposi's sarcoma is often multifocal, but may occur in localized areas. For patients who are immunocompetent and demonstrate slow progression of disease, observation may be acceptable. Occasionally, the disease will regress spontaneously.[9] Goals of therapy are to control symptoms.[13] Classic type Kaposi's sarcoma responds well to radiation treatment.[13] One benefit of this method of treatment is its limited depth of penetration. Local therapy reduces bleeding, debulks, and reduces lymphatic obstruction.[13] Localized and recurrent lesions may be managed by excisional biopsy, laser, cryosurgery, and electrosurgery.[9]

For patients with widespread visceral involvement, a combination of surgery, chemotherapy, and/or radiation may be necessary. Systemic treatment is recommended if the patient is developing greater than 10 new lesions per month, or if there is symptomatic lung disease, lymphedema, or visceral involvement.[12] Chemotherapeutic agents found to be successful in treating Kaposi's sarcoma include vinblastine, bleomycin, doxorubicin, and dacarbazine. Vinblastine has been noted to cause the least myelosuppression.[9] Intralesional interferon is considered experimental. One study found intralesional interferon alfa-2b at a dose of 1 million to 3 million U gave satisfactory results.[6,11] Cryotherapy has also been utilized with 70-percent cosmetic improvement and is useful for small localized lesions only.[3]

In our patient, the ulcers healed in three weeks with conservative care using topical antibiotics, offloading of pressure from the foot with orthotics, and physical therapy. The patient continued on his chemotherapy regimen (Figure 2).

The ulcer healed in three weeks with conservative care: topical antibiotics, offloading of pressure from the foot with orthotics, and physical therapy. The patient continued on his chemotherapy regimen.

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