eMedicine Specialties > Dermatology > Diseases of the Vessels

Kaposi Sarcoma

Author: Robert A Schwartz, MD, MPH, Professor and Head, Dermatology, Professor of Pathology, Pediatrics, Medicine, and Preventive Medicine and Community Health, UMDNJ-New Jersey Medical School
Coauthor(s): W Clark Lambert, MD, PhD, Professor and Head, Dermatopathology, Departments of Pathology and Dermatology, UMDNJ-New Jersey Medical School
Contributor Information and Disclosures

Updated: Apr 23, 2009

Introduction

Background

In 1872, Moritz Kaposi (1837-1902) of Kaposvar, Hungary, a dermatology faculty member at the University of Vienna, first described idiopathisches multiples Pigmentsarkom der Haut, which has become known as Kaposi sarcoma (KS). Kaposi sarcoma had brownish red–to–bluish red cutaneous nodules that tended to enlarge into dome-shaped tumors. Kaposi observed similar neoplasms of the mucosa, especially of the larynx, trachea, stomach, liver, and colon. Kaposi's original 1872 description of 5 patients is more similar to the Kaposi sarcoma seen in AIDS (KS-AIDS) than the Kaposi sarcoma expected in elderly men of Italian, Jewish, or Mediterranean linkage, in whom the disease behavior is benign. Kaposi's original 5 patients died within 2-3 years. Kaposi later updated his data, noting that all of his 16 patients were men with a prognosis that remained unfavorable.

In 1882, Tommaso De Amici, Professor and Head, Dermatology, University of Naples, Italy published in monograph form a detailed analysis of 12 patients with Kaposi sarcoma.1,2

For most of the first 3 quarters of the 20th century, Kaposi sarcoma was viewed as an indolent slowly growing cancer, and patients were expected to die with, rather than of, Kaposi sarcoma. The aggressive course originally noted by Kaposi has become part of the devastation of AIDS, especially among men who are homosexual.3,4

American AIDS was identified relatively recently (1981) in 3 reports of Kaposi sarcoma as an original defining element of AIDS (plus an important editorial and a Centers for Disease Control and Prevention Morbidity and Mortality Weekly Report bulletin). Two of the reports were from New York City, and 1 was from San Francisco. For some time, Kaposi sarcoma was seen in 30-40% of patients with AIDS, often as the presenting sign. The incidence of Kaposi sarcoma has fallen markedly in recent times, although its prevalence has not. The challenge remained to explain the reason patients who are homosexual and have AIDS exhibited Kaposi sarcoma much more commonly than did patients with AIDS unassociated with homosexuality, with the exception of small foci of homosexuals in isolated midwestern communities.

The breakthrough came in 1994, when the Kaposi sarcoma–associated herpes virus (human herpesvirus type 8 [HHV-8]) was identified using representational difference analysis. HHV-8 has been linked closely with all 4 types of Kaposi sarcoma, ie, classic (traditional), endemic (African), epidemic (AIDS related), and iatrogenic (related to immunosuppression).5 Since then, much research has shown that HHV-8 appears to be necessary to, but not sufficient for, the development of Kaposi sarcoma.6

Nevertheless, 2 critical questions remain. Is Kaposi sarcoma a hyperplasia or a neoplasm? Is it always multicentric or can it be metastatic as well? The authors favor the latter interpretation of both points.

Elderly American man of Armenian origin with char...

Elderly American man of Armenian origin with characteristic violaceous plaques of the legs, a good example of classic Kaposi sarcoma.

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Elderly American man of Armenian origin with char...

Elderly American man of Armenian origin with characteristic violaceous plaques of the legs, a good example of classic Kaposi sarcoma.


Pathophysiology

HIV transactivating (tat) gene, cytokine, and HHV-8 stories in Kaposi sarcoma (KS) are fascinating. Each begins with a classic study. In 1988, the human immunodeficiency virus type 1 (HIV-1) tat gene was introduced into transgenic mice, inducing nodules that resembled Kaposi sarcoma in 33 of 37 males but in none of 15 females. Therefore, it appeared that HIV could play a direct role in causing Kaposi sarcoma.

The second saga was a result of efforts to grow Kaposi sarcoma cells in culture, requiring a long-term growth factor. Conditioned medium from T cells infected with human T-cell leukemia virus type II (rather than HIV-1 or human T-cell leukemia virus type I) best supported the growth and long-term culture of Kaposi sarcoma cells derived from KS-AIDS lesions. In 1992, this growth factor proved to be a cytokine previously termed oncostatin M, since it had been identified earlier for its inhibitory effects on a variety of cancer cells. Another cytokine scatter factor was found in large quantities in this medium, inducing endothelial cells to demonstrate a Kaposi sarcoma tumor cell-like phenotype. The importance of oncostatin M, scatter factor, and the tat protein has been shown in the pathogenesis of Kaposi sarcoma.

Other cytokines, including interleukin 1 (IL-1), tumor necrosis factor, interleukin 6 (IL-6), and basic fibroblastic growth factor (bFGF), may work synergistically with the HIV tat gene product. Scatter factor may be involved both in initiation and in maintenance of Kaposi sarcoma. Scatter factor stimulates endothelial cells to migrate nearby and become factor XIIIa–positive c-Met- expressing spindle-shaped Kaposi sarcoma cells. The cells further expand neovascularization by producing cytokines and promoting autocrine-mediated and paracrine-mediated growth of Kaposi sarcoma cells. The scatter factor receptor, c-Met proto-oncogene, is expressed by Kaposi sarcoma cells; the oncogene int-2 of the fibroblast growth factor family also may be evident.

Herpes-type viruses have been linked with Kaposi sarcoma for more than 3 decades. A landmark study showed short DNA sequences of a unique human herpesvirus in Kaposi sarcoma tissues via a new molecular biological technique termed representational difference analysis. They resembled herpesvirus saimiri but proved to be a new type of human herpesvirus now termed HHV-8. This virus appears to interact with the HIV tat protein, excess levels of basic fibroblast growth factor, scatter factor, and IL-6. For example, HHV-8–encoded IL-6 has been found to induce endogenous human IL-6 secretion. An HHV-8 oncogene, Kaposin (ORF K12), has been characterized; however, additional factors remain to be found. For example, a 53% prevalence of HHV-8 subtype E in Brazilian Indians does not appear to be linked with the development of Kaposi sarcoma in this population.7

Classic Kaposi sarcoma is seen in Italy with hot spots being in the Po River Valley, Sardinia, and southern Italy. It has been suggested that volcanic soil or birthplace/residency in areas abundant with bloodsucking insects may be a risk factor.8 A survey evaluated the correlation between HHV-8 infection and classic Kaposi sarcoma incidence in northern Sardinia.9 It revealed that seroprevalence was 35%, within a range of 15.3-46.3% in the five areas. Age was as an important risk factor. Subjects aged older than 50 years had a higher seroprevalence to HHV-8 as compared with younger individuals. A strong direct correlation between HHV-8 prevalence and classic Kaposi sarcoma incidence was also observed.

Kaposi sarcoma–associated herpesvirus (KSHV), or human herpesvirus 8 (HHV-8), is the most frequent cause of malignancy in patients with AIDS.10 KSHV and related herpesviruses have pirated cellular cDNAs from the host genome. Many of the viral regulatory homologs encode proteins that directly inhibit host adaptive and innate immunity. Other viral proteins may target retinoblastoma protein and p53 control of tumor suppressor pathways, which play key effector roles in intracellular immune responses. The immune evasion strategies used by KSHV in targeting tumor suppressor pathways activated during immune system signaling, may lead to inadvertent cell proliferation and tumorigenesis in susceptible hosts.

The origin of the spindle cell, the hallmark cell of Kaposi sarcoma, is unknown. Most research favors a lymphatic endothelial cell or an endothelial-cell precursor evolving into a lymphatic phenotype, both preferentially targeted by KSHV.11

Frequency

United States

The incidence of Kaposi sarcoma (KS) has been estimated at 0.02-0.06%. Traditional Kaposi sarcoma of middle-aged and older American men of Mediterranean and Eastern European (Ashkenazi) Jewish lineage represents approximately 0.2% of cancer cases in the United States. Iatrogenic Kaposi sarcoma has a 400% increased incidence compared to the American population at large. The incidence of Kaposi sarcoma among American renal transplant recipients is approximately 0.4%. In the AIDS grouping, Kaposi sarcoma originally accounted for as many as 35% of patients, an incidence that has been declining with early detection of AIDS, although Kaposi sarcoma prevalence may remain high. In the United States, a few emigrants arrive from Kaposi sarcoma–endemic regions (primarily Africa). The largest immigrant population in this category may be Haitians; however, recent evidence suggests that Haitian AIDS originated directly in New York rather than Africa.

International

Four groups are predisposed to Kaposi sarcoma including (1) older men of Mediterranean and Jewish lineage; (2) Africans from areas including Uganda, the Congo Republic, Congo (Brazzaville), and Zambia; (3) persons who are iatrogenically immunosuppressed; and (4) men who are homosexual. Kaposi sarcoma traditionally is an uncommon disease in middle-aged and elderly European men of Mediterranean or Jewish lineage. A similar focus of Kaposi sarcoma exists in the same age and sex groups in Africa. If a crudely calculated incidence of 28 cases of Kaposi sarcoma per 100,000 in the Arabian population is correct, Kaposi sarcoma may be more common among Arabians than among Mediterranean people. A previously unrecognized genetic predisposition for Kaposi sarcoma among Arabians has been suggested. The incidence of Kaposi sarcoma among renal transplant recipients may be as high as 3.5% or higher in regions endemic for Kaposi sarcoma, which is significantly higher than the 0.4% incidence renal transplant recipients in the United States and Western Europe.

Endemic African Kaposi sarcoma has accounted for 10% of cancers and has been seen in a male-to-female ratio of 15:1. The Kampala Cancer Registry, one of the continent's first and foremost, has shown a significant alteration in the incidence of Kaposi sarcoma in the era of AIDS. In Uganda, Kaposi sarcoma has caused almost one half (48.9%) of cancer cases in men and 17.9% in women. The incidence in men (30.1 cases per 100,000) represents a more than 10-fold increase in men since the 1950s and is approximately 3 times the incidence found in women (11 cases per 100,000). The incidence in boys and girls was approximately the same in childhood (birth to 14 y), with small peaks in girls younger than 5 years and boys aged 5-9 years. Subsequently, a progressive rise in incidence peaked in women aged 25-29 years and in men aged 35-39 years. Lymphadenopathic Kaposi sarcoma affected 12% of total cases; 42% of childhood cases were of this type.

In neighboring Zambia, the disorder was particularly aggressive among children, more than 80% of whom were HIV seropositive. Kaposi sarcoma was found to represent as much as 25% of childhood cancers. The average male-to-female ratio was 1.76:1, with male predominance higher in children older than 5 years (2.5:1 ratio) than in children younger than 5 years (1.4:1 ratio). The prevalence of HIV-related Kaposi sarcoma seems to be increasing in Nigeria, probably owing to more females having HIV disease.12

In Italy, KS-AIDS has produced notable epidemiologic changes. A doubling of Kaposi sarcoma incidence rates was noted in Italian men younger than 50 years from 1976-1984 to 1985-1990; however, no change, or possibly a decline, was observed in older men. The incidence of Kaposi sarcoma was estimated in the region around Venice, Italy, with rates higher in the coast and alpine valleys; in the latter, there was an excess of cases for both sexes combined (SIR = 191.1; CI = 113.2-302.0).8

Classic Kaposi sarcoma in Greece seems to have an older age of onset; lower male-to-female ratio; endemic clustering; and disseminated skin disease at diagnosis, often accompanied by lymphedema and not unusual visceral or lymph node involvement.13,14,15 A clustering was noted, with a high proportion of the patients being born in Peloponnesos (42.42%) and residing in Athens (51.51%) or in Peloponnesos (24.24%).

The incidence rates of classic Kaposi sarcoma in Italy after the spread of AIDS was evaluated.9 The rates were 1 case per 100,000 population in men and 0.4 case per 100,000 population in women, varying from 0.3 cases per 100,000 population for men in Umbria and 4.7 cases per 100,000 population for men in Sassari in men and from 0.1 case per 100,000 population for women in Parma and 1.7 cases per 100,000 population for women in Sassari.

The rate of classic Kaposi sarcoma in southern Sardinia (Italy) from 1998-2002 was found to be 2.49 cases per 100 000 population per year (standardized), which was the highest rate recorded in the island.18

Mortality/Morbidity

Patients with traditional Kaposi sarcoma (KS) tend to die with Kaposi sarcoma rather than of Kaposi sarcoma. Patients with KS-AIDS usually die from associated opportunistic infections or from gastrointestinal Kaposi sarcoma with hemorrhage. The mean survival rate of patients with KS-AIDS has been approximately 15-24 months, although the introduction into the United States of apparent immune system reconstitution using highly active antiretroviral therapy (HAART) has extended survival substantially. Kaposi sarcoma also may be fatal as a result of gut perforation, cardiac tamponade, massive pulmonary obstruction or, rarely, brain metastases.

  • In Kaposi's original description, death usually ensued within 3 years and was linked to fever, diarrhea, and hemoptysis. Inanition may be an important factor, and death may ensue as a result of bulky tumor obstructing the bronchi or larynx.
  • Patients with AIDS-related Kaposi sarcoma often have widespread visceral Kaposi sarcoma, although Kaposi sarcoma limited to the skin also is common.
  • Patients with iatrogenic Kaposi sarcoma tend to have gut bleeding resulting from Kaposi sarcoma, although termination or reduction of immunosuppression often, but not always, results in regression of Kaposi sarcoma.

Race

Kaposi sarcoma is an uncommon disease of middle-aged and elderly American and European men of Mediterranean or Jewish lineage. This propensity also is seen in individuals with iatrogenically induced Kaposi sarcoma but not among persons in the KS-AIDS group. Kaposi sarcoma is rare in American blacks, despite its large foci among blacks in certain regions of Africa.

Sex

Classic Kaposi sarcoma has an overwhelming male predominance, with a male-to-female ratio of approximately 10-15:1.

  • For endemic Kaposi sarcoma in Central Africa, the male-to-female ratio is near unity in childhood Kaposi sarcoma cases but often rises in puberty to 15:1.
  • In Corsica and Sardinia (where classic Kaposi sarcoma is endemic), with the arrival of AIDS, the ratio of male-to-female cases has dropped from 10:1 to 3:1. Children of women who are HIV-1 seropositive without Kaposi sarcoma have an aggressive form of childhood HIV-associated Kaposi sarcoma. A male-to-female ratio of 1.5:1 was observed.
  • A male-to-female ratio of 1.5:1 also was evident among renal transplant recipients in Arabia.19
  • In Zambia, Kaposi sarcoma represents up to 25% of childhood cancers and has an average male-to-female ratio of 1.76:1, with male predominance higher in children older than 5 years (2.5:1) than in children younger than 5 years (1.4:1).

Age

Age distribution depends on the type of Kaposi sarcoma.

  • In the United States and Europe, traditional Kaposi sarcoma has a peak incidence between 40-70 years, with a wide range of up to 89 years.
  • Young men with KS-AIDS who are homosexual also show a wide age range but tend to be much younger, averaging 20-40 years at age of onset.
  • For endemic Kaposi sarcoma in Uganda, the incidence in boys and girls was approximately the same in childhood (birth to 14 y), with a small peak in girls younger than 5 years and boys aged 5-9 years. Subsequently, a progressive rise in incidence peaked in women aged 25-29 years and in men aged 35-39 years.

Clinical

History

  • Kaposi sarcoma (KS) is a neoplasm that often manifests with multiple vascular nodules in the skin and other organs.
  • Although true metastases appear to occur, a multifocal origin is most common.
  • The pattern of Kaposi sarcoma is variable, with a course ranging from indolent (only skin manifestations) to fulminant (extensive visceral involvement).
  • Kaposi sarcoma also may arise primarily in the oral mucosa, lymph nodes, and/or viscera without skin involvement.


Oral Kaposi sarcoma.

Oral Kaposi sarcoma.

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Oral Kaposi sarcoma.

Oral Kaposi sarcoma.


  • Kaposi sarcoma initially may be evident in any organ of the body.
  • Chronic lymphedema may precede Kaposi sarcoma.
  • Professor Ruocco's term isotopic response applies to the occurrence of Kaposi sarcoma with new cutaneous nodules at the site of other, unrelated, and already healed skin diseases.20
  • Although primary penile Kaposi sarcoma is uncommon in HIV negative men, one should consider this possibility when treating nonspecific penile lesions.21 A minimal penile lesion with nondistinctive clinical features may be the exclusive manifestation of Kaposi sarcoma. In addition, it may appear as a skin-colored nodule suggestive of a primary squamous cell carcinoma.22 Clearly, in both cases, histologic evaluation is mandated to establish the diagnosis.

Physical

Kaposi sarcoma (KS) is described in 3 forms including localized nodular, locally aggressive, and generalized Kaposi sarcoma. Kaposi sarcoma typically occurs in these 3 forms and in 6 stages including patch, plaque, nodular, exophytic, infiltrative, and lymphadenopathic.

  • Cutaneous Kaposi sarcoma usually begins as discrete red or purple patches that are bilaterally symmetric and initially tend to involve the lower extremities.
  • Patches become elevated, evolving into nodules and plaques.
  • Nodules may be spongy to the touch.
Man who is homosexual and has HIV infection and K...

Man who is homosexual and has HIV infection and Kaposi sarcoma.

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Man who is homosexual and has HIV infection and K...

Man who is homosexual and has HIV infection and Kaposi sarcoma.


Man who is homosexual and has HIV infection and K...

Man who is homosexual and has HIV infection and Kaposi sarcoma.

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Man who is homosexual and has HIV infection and K...

Man who is homosexual and has HIV infection and Kaposi sarcoma.


Man who is homosexual and has HIV infection and K...

Man who is homosexual and has HIV infection and Kaposi sarcoma.

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Man who is homosexual and has HIV infection and K...

Man who is homosexual and has HIV infection and Kaposi sarcoma.


Man who is homosexual and has HIV infection and K...

Man who is homosexual and has HIV infection and Kaposi sarcoma.

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Man who is homosexual and has HIV infection and K...

Man who is homosexual and has HIV infection and Kaposi sarcoma.


Man who is homosexual and has HIV infection and K...

Man who is homosexual and has HIV infection and Kaposi sarcoma.

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Man who is homosexual and has HIV infection and K...

Man who is homosexual and has HIV infection and Kaposi sarcoma.


Man who is homosexual and has HIV infection and K...

Man who is homosexual and has HIV infection and Kaposi sarcoma.

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Man who is homosexual and has HIV infection and K...

Man who is homosexual and has HIV infection and Kaposi sarcoma.


  • Kaposi sarcoma also occurs as a large infiltrating mass or as multiple cone-shaped friable tumors. These 2 variants, termed locally aggressive Kaposi sarcoma, may adhere firmly to underlying anatomic structures including bone.
A 35-year-old man with dome-shaped locally aggres...

A 35-year-old man with dome-shaped locally aggressive tumors, an example of exophytic Kaposi sarcoma with cavernous hemangiomalike histology.

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A 35-year-old man with dome-shaped locally aggres...

A 35-year-old man with dome-shaped locally aggressive tumors, an example of exophytic Kaposi sarcoma with cavernous hemangiomalike histology.


Elderly man of Mediterranean lineage with hyperke...

Elderly man of Mediterranean lineage with hyperkeratotic nodule of Kaposi sarcoma on sole of foot.

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Elderly man of Mediterranean lineage with hyperke...

Elderly man of Mediterranean lineage with hyperkeratotic nodule of Kaposi sarcoma on sole of foot.


  • Early Kaposi sarcoma may appear as violaceous patches (patch stage Kaposi sarcoma), which occasionally resemble large junctional melanocytic nevi or may appear as irregular-shaped patches similar to the nevus flammeus.
  • More commonly, Kaposi sarcoma is evident as violaceous plaques or nodules on the lower extremities. The nodules tend to enlarge into dome-shaped tumors.
  • Cutaneous Kaposi sarcoma rarely may be infiltrative or exophytic. To the authors' knowledge, infiltrative Kaposi sarcoma has not been described outside of Africa. Exophytic Kaposi sarcoma may erode downward into bone.
  • Lymphadenopathic Kaposi sarcoma may demonstrate skin lesions.
  • At times, a Köbner phenomenon appears evident, with nodules at sites of trauma.
  • A few unusual varieties of Kaposi sarcoma also exist.
    • Telangiectatic Kaposi sarcoma is an eruption of pink translucent nodules with prominent telangiectasia.
    • Ecchymotic Kaposi sarcoma appears as periorbital ecchymoses. Histologically, there is a large amount of extravasated red blood cells, no evidence of amyloidosis, and a dermis containing foci of proliferating moderately atypical spindle cells, vascular slits, erythrophagocytosis, and other features of Kaposi sarcoma. On the trunk, lesions often follow skin tension lines.
Ecchymotic Kaposi sarcoma in a man who is homosex...

Ecchymotic Kaposi sarcoma in a man who is homosexual.

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Ecchymotic Kaposi sarcoma in a man who is homosex...

Ecchymotic Kaposi sarcoma in a man who is homosexual.


    • Keloidal Kaposi sarcoma is evident as somewhat brown-to-violaceous keloidal nodules. Histologically, these are Kaposi sarcoma nodules with a keloidal component.
    • Cavernous Kaposi sarcoma is a rare type of locally aggressive Kaposi sarcoma characterized by cutaneous tumors that histologically resemble cavernous hemangiomas; however, the endothelial cells and their nuclei are large and prominent, bulging into the cavity.
    • Lymphangiomalike Kaposi sarcoma is a rare variant in which dilated vascular spaces produce a bullous-appearing eruption, typically on the lower legs. The lesions are easily compressible and appear clinically to be fluid-filled. The vascular channels are lined by banal-appearing endothelial cells permeating the dermis in the absence of spindle cell proliferation.

Causes

HHV-8 has been linked convincingly with all 4 types of KS, an association that is necessary, but not sufficient, to develop KS; therefore, other factors also are important. At this point, immunosuppression appears to be the most significant cofactor.

The use of prednisolone as an adjunct to treatment in HIV-1–associated pleural tuberculosis in Uganda was associated with a significantly higher incidence of KS (4.2 cases per 100 person-years, compared with 0 cases per 100 person-years [P = .02]),23 which is a dramatic example of the induction of KS by immunosuppressive therapy with corticosteroids.

More on Kaposi Sarcoma

Overview: Kaposi Sarcoma
Differential Diagnoses & Workup: Kaposi Sarcoma
Treatment & Medication: Kaposi Sarcoma
Follow-up: Kaposi Sarcoma
Multimedia: Kaposi Sarcoma
References
Further Reading
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References

  1. Ronchese F. Kaposi's sarcoma; an overlooked essay of 1882. AMA Arch Derm. May 1958;77(5):542-5. [Medline].

  2. Schiavo AL, Ruocco V, Marino F, Ferraiolo S, Pinto F, Orlando G. Tommaso de Amicis, Augusto Ducrey, Lodovico Tommasi: three Neapolitan stars in the dermatovenereology firmament. Int J Dermatol. Jan 1996;35(1):57-62. [Medline].

  3. Borkovic SP, Schwartz RA. Kaposi's sarcoma presenting in the homosexual man -- a new and striking phenomenon!. Ariz Med. Dec 1981;38(12):902-4. [Medline].

  4. Borkovic SP, Schwartz RA. Kaposi's sarcoma. Am Fam Physician. Oct 1982;26(4):133-7. [Medline].

  5. Allan AE, Shoji T, Li N, Burlage A, Davis B, Bhawan J. Two cases of Kaposi's sarcoma mimicking Stewart-Treves syndrome found to be human herpesvirus-8 positive. Am J Dermatopathol. Oct 2001;23(5):431-6. [Medline].

  6. Schwartz RA, Micali G, Nasca MR, Scuderi L. Kaposi sarcoma: a continuing conundrum. J Am Acad Dermatol. Aug 2008;59(2):179-206; quiz 207-8. [Medline].

  7. Biggar RJ, Whitby D, Marshall V, Linhares AC, Black F. Human herpesvirus 8 in Brazilian Amerindians: a hyperendemic population with a new subtype. J Infect Dis. May 2000;181(5):1562-8. [Medline].

  8. Ascoli V, Zambon P, Manno D, et al. Variability in the incidence of classic Kaposi's sarcoma in the Veneto region, Northern Italy. Tumori. Mar-Apr 2003;89(2):122-4. [Medline].

  9. Santarelli R, De Marco R, Masala MV, et al. Direct correlation between human herpesvirus-8 seroprevalence and classic Kaposi's sarcoma incidence in Northern Sardinia. J Med Virol. Oct 2001;65(2):368-72. [Medline].

  10. Moore PS, Chang Y. Kaposi's sarcoma-associated herpesvirus immunoevasion and tumorigenesis: two sides of the same coin?. Annu Rev Microbiol. 2003;57:609-39. [Medline].

  11. Dupin N, Grange PA. Looking for the target cell of Kaposi's sarcoma-associated herpesvirus. J Invest Dermatol. Mar 2006;126(3):545-7. [Medline].

  12. Onunu AN, Okoduwa C, Eze EU, Adeyekun AA, Kubeyinje EP, Schwartz RA. Kaposi's sarcoma in Nigeria. Int J Dermatol. Mar 2007;46(3):264-7. [Medline].

  13. Stratigos JD, Potouridou I, Katoulis AC, et al. Classic Kaposi's sarcoma in Greece: a clinico-epidemiological profile. Int J Dermatol. Oct 1997;36(10):735-40. [Medline].

  14. Barco D, Alegre M, Alomar A. [Classic kaposi sarcoma associated with lymphedema following arterial catheterization]. Actas Dermosifiliogr. Oct 2008;99(8):665-7. [Medline].

  15. Ruocco V, Schwartz RA, Ruocco E. Lymphedema: an immunologically vulnerable site for development of neoplasms. J Am Acad Dermatol. Jul 2002;47(1):124-7. [Medline].

  16. Dal Maso L, Polesel J, Ascoli V, et al. Classic Kaposi's sarcoma in Italy, 1985-1998. Br J Cancer. Jan 17 2005;92(1):188-93. [Medline].

  17. Atzori L, Fadda D, Ferreli C, et al. Classic Kaposi's sarcoma in southern Sardinia, Italy. Br J Cancer. Oct 4 2004;91(7):1261-2. [Medline].

  18. Qunibi W, Al-Furayh O, Almeshari K, et al. Serologic association of human herpesvirus eight with posttransplant Kaposi's sarcoma in Saudi Arabia. Transplantation. Feb 27 1998;65(4):583-5. [Medline].

  19. Wolf R, Brenner S, Ruocco V, Filioli FG. Isotopic response. Int J Dermatol. May 1995;34(5):341-8. [Medline].

  20. Micali G, Nasca MR, De Pasquale R, Innocenzi D. Primary classic Kaposi's sarcoma of the penis: report of a case and review. J Eur Acad Dermatol Venereol. May 2003;17(3):320-3. [Medline].

  21. Schwartz RA, Cohen JB, Watson RA, et al. Penile Kaposi's sarcoma preceded by chronic penile lymphoedema. Br J Dermatol. Jan 2000;142(1):153-6. [Medline].

  22. Elliott AM, Luzze H, Quigley MA, et al. A randomized, double-blind, placebo-controlled trial of the use of prednisolone as an adjunct to treatment in HIV-1-associated pleural tuberculosis. J Infect Dis. Sep 1 2004;190(5):869-78. [Medline].

  23. Straka L, Adamicová K. [Reactive angioendotheliomatosis--a rare disease mimicking Kaposi sarcoma: a case report]. Cesk Patol. Oct 2004;40(4):162-6. [Medline].

  24. Patel RM, Goldblum JR, Hsi ED. Immunohistochemical detection of human herpes virus-8 latent nuclear antigen-1 is useful in the diagnosis of Kaposi sarcoma. Mod Pathol. Apr 2004;17(4):456-60. [Medline].

  25. O'Mahony D, Gandjbakche A, Hassan M, Vogel A, Yarchoan R. Imaging techniques for Kaposi's sarcoma. J HIV Ther. Sep 2008;13(3):65-71. [Medline].

  26. Theron S, Andronikou S, Du Plessis J, et al. Pulmonary Kaposi sarcoma in six children. Pediatr Radiol. Dec 2007;37(12):1224-9. [Medline].

  27. Luzar B, Antony F, Ramdial PK, Calonje E. Intravascular Kaposi's sarcoma - a hitherto unrecognized phenomenon. J Cutan Pathol. Nov 2007;34(11):861-4. [Medline].

  28. Wada DA, Perkins SL, Tripp S, Coffin CM, Florell SR. Human herpesvirus 8 and iron staining are useful in differentiating Kaposi sarcoma from interstitial granuloma annulare. Am J Clin Pathol. Feb 2007;127(2):263-70. [Medline].

  29. Brambilla L, Boneschi V, Taglioni M, Ferrucci S. Staging of classic Kaposi's sarcoma: a useful tool for therapeutic choices. Eur J Dermatol. Jan-Feb 2003;13(1):83-6. [Medline].

  30. Krown SE, Metroka C, Wernz JC. Kaposi's sarcoma in the acquired immune deficiency syndrome: a proposal for uniform evaluation, response, and staging criteria. AIDS Clinical Trials Group Oncology Committee. J Clin Oncol. Sep 1989;7(9):1201-7. [Medline].

  31. Mitsuyasu RT. Clinical variants and staging of Kaposi's sarcoma. Semin Oncol. Jun 1987;14(2 Suppl 3):13-8. [Medline].

  32. Fardet L, Stoebner PE, Bachelez H, et al. Treatment with taxanes of refractory or life-threatening Kaposi sarcoma not associated with human immunodeficiency virus infection. Cancer. Apr 15 2006;106(8):1785-9. [Medline].

  33. Di Lorenzo G, Di Trolio R, Montesarchio V, et al. Pegylated liposomal doxorubicin as second-line therapy in the treatment of patients with advanced classic Kaposi sarcoma: a retrospective study. Cancer. Mar 1 2008;112(5):1147-52. [Medline].

  34. Klein E, Schwartz RA, Laor Y, Milgrom H, Burgess GH, Holtermann OA. Treatment of Kaposi's sarcoma with vinblastine. Cancer. Feb 1980;45(3):427-31. [Medline].

  35. Goiriz R, Rios-Buceta L, De Arriba AG, Aragues M, Garcia-Diez A. Treatment of classic Kaposi's sarcoma with topical imiquimod. Dermatol Surg. Jan 2009;35(1):147-9. [Medline].

  36. Rubegni P, Sbano P, De Aloe G, Flori ML, Fimiani M. Thalidomide in the treatment of Kaposi's sarcoma. Dermatology. 2007;215(3):240-4. [Medline].

  37. Paghdal KV, Schwartz RA. Sirolimus (rapamycin): from the soil of Easter Island to a bright future. J Am Acad Dermatol. Dec 2007;57(6):1046-50. [Medline].

  38. Boratynska M, Watorek E, Smolska D, Patrzalek D, Klinger M. Anticancer effect of sirolimus in renal allograft recipients with de novo malignancies. Transplant Proc. Nov 2007;39(9):2736-9. [Medline].

  39. Leder HA, Galor A, Peters GB, Kedhar SR, Dunn JP, Thorne JE. Resolution of conjunctival Kaposi sarcoma after institution of highly active antiretroviral therapy alone. Br J Ophthalmol. Jan 2008;92(1):151. [Medline].

  40. Olweny CL, Borok M, Gudza I, et al. Treatment of AIDS-associated Kaposi's sarcoma in Zimbabwe: results of a randomized quality of life focused clinical trial. Int J Cancer. Feb 10 2005;113(4):632-9. [Medline].

  41. Cattani P, Capuano M, Graffeo R, et al. Kaposi's sarcoma associated with previous human herpesvirus 8 infection in kidney transplant recipients. J Clin Microbiol. Feb 2001;39(2):506-8. [Medline].

  42. Frances C, Mouquet C, Marcelin AG, et al. Outcome of kidney transplant recipients with previous human herpesvirus-8 infection. Transplantation. May 15 2000;69(9):1776-9. [Medline].

  43. Khan MY, Khanam H, Koneru B, Schwartz RA. Kaposi's sarcoma in a liver transplant series. J Med. 1999;30(3-4):185-90. [Medline].

  44. Khan MY, Khanman H, Koneru B. Kaposi's sarcoma in a liver transplantation series. J Med. 2000;30:185-90.

  45. Sabeel AI, Qunibi WY, Alfurayh OA, Al-Meshari K. Kaposi's sarcoma in Sudanese renal transplant recipients: a report from a single center. J Nephrol. May-Jun 2003;16(3):412-6. [Medline].

  46. Pitche PT, Kombate K, Owono F, Tchangai-Walla K. Kaposi's sarcoma in a hospital setting in Lome (Togo): a study of 93 cases. Int J Dermatol. Oct 2007;46 Suppl 1:42-4. [Medline].

  47. Anderson LA, Lauria C, Romano N, et al. Risk factors for classical Kaposi sarcoma in a population-based case-control study in Sicily. Cancer Epidemiol Biomarkers Prev. Dec 2008;17(12):3435-43. [Medline].

  48. Cerimele D, Cottoni F, Masala MV. Long latency of human herpesvirus type 8 infection and the appearance of classic Kaposi's sarcoma. J Am Acad Dermatol. Oct 2000;43(4):731-2. [Medline].

  49. Coluzzi M, Manno D, Guzzinati S, et al. The bloodsucking arthropod bite as possible cofactor in the transmission of human herpesvirus-8 infection and in the expression of Kaposi's sarcoma disease. Parassitologia. Jun 2002;44(1-2):123-9. [Medline].

  50. Cook PM, Whitby D, Calabro ML, et al. Variability and evolution of Kaposi's sarcoma-associated herpesvirus in Europe and Africa. International Collaborative Group. AIDS. Jul 9 1999;13(10):1165-76. [Medline].

  51. Cottoni F, Masala MV, Budroni M, et al. The role of occupation and a past history of malaria in the etiology of classic Kaposi's sarcoma: a case-control study in north-east Sardinia. Br J Cancer. 1997;76(11):1518-20. [Medline].

  52. Cottoni F, Masala MV, Piras P, Montesu MA, Cerimele D. Mucosal involvement in classic Kaposi's sarcoma. Br J Dermatol. Jun 2003;148(6):1273-4. [Medline].

  53. Cottoni F, Masia IM, Cossu S, Montesu MA, Pardini S, Massarelli G. Classical Kaposi's sarcoma and chronic lymphocytic leukaemia in the same skin biopsy. Report of two cases. Br J Dermatol. Oct 1998;139(4):753-4. [Medline].

  54. Davis DA, Scott DM. Lymphangioma-like Kaposi's sarcoma: etiology and literature review. J Am Acad Dermatol. Jul 2000;43(1 Pt 1):123-7. [Medline].

  55. De Pasquale R, Nasca MR, Micali G. Postirradiation primary Kaposi's sarcoma of the head and neck. J Am Acad Dermatol. Feb 1999;40(2 Pt 2):312-4. [Medline].

  56. Dourmishev LA, Dourmishev AL, Palmeri D, Schwartz RA, Lukac DM. Molecular genetics of Kaposi's sarcoma-associated herpesvirus (human herpesvirus-8) epidemiology and pathogenesis. Microbiol Mol Biol Rev. Jun 2003;67(2):175-212, table of contents. [Medline].

  57. Edelman DC, Ketema F, Saville RD, et al. Specifics on the refinement and application of two serological assays for the detection of antibodies to HHV-8. J Clin Virol. May 2000;16(3):225-37. [Medline].

  58. Folpe AL, Veikkola T, Valtola R, Weiss SW. Vascular endothelial growth factor receptor-3 (VEGFR-3): a marker of vascular tumors with presumed lymphatic differentiation, including Kaposi's sarcoma, kaposiform and Dabska-type hemangioendotheliomas, and a subset of angiosarcomas. Mod Pathol. Feb 2000;13(2):180-5. [Medline].

  59. Foreman KE, Alkan S, Krueger AE, Panella JR, Swinnen LJ, Nickoloff BJ. Geographically distinct HHV-8 DNA sequences in Saudi Arabian Iatrogenic Kaposi's sarcoma lesions. Am J Pathol. Sep 1998;153(3):1001-4. [Medline].

  60. Franceschi S, Dal Maso L, Pezzotti P, et al. Incidence of AIDS-defining cancers after AIDS diagnosis among people with AIDS in Italy, 1986-1998. J Acquir Immune Defic Syndr. Sep 1 2003;34(1):84-90. [Medline].

  61. Gascon P, Schwartz RA. Kaposi's sarcoma. New treatment modalities. Dermatol Clin. Jan 2000;18(1):169-75, x. [Medline].

  62. Gascon P, Schwartz RA. Treatment of Kaposi's sarcoma. Dermatol Clin. Apr 1994;12(2):451-6. [Medline].

  63. Goudsmit J, Renwick N, Dukers NH, et al. Human herpesvirus 8 infections in the Amsterdam Cohort Studies (1984-1997): analysis of seroconversions to ORF65 and ORF73. Proc Natl Acad Sci U S A. Apr 25 2000;97(9):4838-43. [Medline].

  64. Hengge UR, Ruzicka T, Tyring SK, et al. Update on Kaposi's sarcoma and other HHV8 associated diseases. Part 1: epidemiology, environmental predispositions, clinical manifestations, and therapy. Lancet Infect Dis. May 2002;2(5):281-92. [Medline].

  65. Hengge UR, Ruzicka T, Tyring SK, et al. Update on Kaposi's sarcoma and other HHV8 associated diseases. Part 2: pathogenesis, Castleman's disease, and pleural effusion lymphoma. Lancet Infect Dis. Jun 2002;2(6):344-52. [Medline].

  66. Hjalgrim H, Tulinius H, Dalberg J, Hardarson S, Frisch M, Melbye M. High incidence of classical Kaposi's sarcoma in Iceland and the Faroe Islands. Br J Cancer. Apr 1998;77(7):1190-3. [Medline].

  67. Hoshaw RA, Schwartz RA. Kaposi's sarcoma after immunosuppressive therapy with prednisone. Arch Dermatol. Nov 1980;116(11):1280-2. [Medline].

  68. Husain SR, Puri RK. Interleukin-13 fusion cytotoxin as a potent targeted agent for AIDS-Kaposi's sarcoma xenograft. Blood. Jun 1 2000;95(11):3506-13. [Medline].

  69. Judde JG, Lacoste V, Briere J, et al. Monoclonality or oligoclonality of human herpesvirus 8 terminal repeat sequences in Kaposi's sarcoma and other diseases. J Natl Cancer Inst. May 3 2000;92(9):729-36. [Medline].

  70. Kaposi M. Idiopathisches multiples Pigmentsarkom der Haut. Arch Dermatol Syph (Prague). 1872;4:265-273.

  71. Katano H, Iwasaki T, Baba N, et al. Identification of antigenic proteins encoded by human herpesvirus 8 and seroprevalence in the general population and among patients with and without Kaposi's sarcoma. J Virol. Apr 2000;74(8):3478-85. [Medline].

  72. Kirshner JR, Lukac DM, Chang J, Ganem D. Kaposi's sarcoma-associated herpesvirus open reading frame 57 encodes a posttranscriptional regulator with multiple distinct activities. J Virol. Apr 2000;74(8):3586-97. [Medline].

  73. Koehler JE, Sanchez MA, Garrido CS, et al. Molecular epidemiology of bartonella infections in patients with bacillary angiomatosis-peliosis. N Engl J Med. Dec 25 1997;337(26):1876-83. [Medline].

  74. Kolios G, Kaloterakis A, Filiotou A, Nakos A, Hadziyannis S. Gastroscopic findings in Mediterranean Kaposi's sarcoma (non-AIDS). Gastrointest Endosc. Oct 1995;42(4):336-9. [Medline].

  75. Krigel RL, Laubenstein LJ, Muggia FM. Kaposi's sarcoma: a new staging classification. Cancer Treat Rep. Jun 1983;67(6):531-4. [Medline].

  76. Krischer J, Rutschmann O, Hirschel B, Vollenweider-Roten S, Saurat JH, Pechere M. Regression of Kaposi's sarcoma during therapy with HIV-1 protease inhibitors: a prospective pilot study. J Am Acad Dermatol. Apr 1998;38(4):594-8. [Medline].

  77. Laor Y, Schwartz RA. Epidemiologic aspects of american Kaposi's sarcoma. J Surg Oncol. Dec 1979;12(4):299-303. [Medline].

  78. Leitch H, Trudeau M, Routy JP. Effect of protease inhibitor-based highly active antiretroviral therapy on survival in HIV-associated advanced Kaposi's sarcoma patients treated with chemotherapy. HIV Clin Trials. Mar-Apr 2003;4(2):107-14. [Medline].

  79. Lothe F. Kaposi's sarcoma in Uganda Africans. Acta Pathol Microbiol Scand Suppl. 1963;Suppl 161:1+. [Medline].

  80. Lukac DM, Kirshner JR, Ganem D. Transcriptional activation by the product of open reading frame 50 of Kaposi's sarcoma-associated herpesvirus is required for lytic viral reactivation in B cells. J Virol. Nov 1999;73(11):9348-61. [Medline].

  81. Mancuso R, Biffi R, Valli M, et al. HHV8 a subtype is associated with rapidly evolving classic Kaposi's sarcoma. J Med Virol. Dec 2008;80(12):2153-60. [Medline].

  82. Maral T. The Koebner phenomenon in immunosuppression-related Kaposi's sarcoma. Ann Plast Surg. Jun 2000;44(6):646-8. [Medline].

  83. Marfella A, Ruocco V, Capobianco A, et al. Neopterin and alpha-interferon in patients affected by Kaposi's sarcoma from Africa. Eur J Cancer Clin Oncol. Aug 1989;25(8):1145-50. [Medline].

  84. Martin JN, Ganem DE, Osmond DH, Page-Shafer KA, Macrae D, Kedes DH. Sexual transmission and the natural history of human herpesvirus 8 infection. N Engl J Med. Apr 2 1998;338(14):948-54. [Medline].

  85. Micali G, Gasparri O, Nasca MR, Sapuppo A. Kaposi's sarcoma occurring de novo in the surgical scar in a heart transplant recipient. J Am Acad Dermatol. Aug 1992;27(2 Pt 1):273-4. [Medline].

  86. Moore PS, Chang Y. Kaposi's sarcoma (KS), KS-associated herpesvirus, and the criteria for causality in the age of molecular biology. Am J Epidemiol. Feb 1 1998;147(3):217-21. [Medline].

  87. Morgan D, Malamba SS, Orem J, Mayanja B, Okongo M, Whitworth JA. Survival by AIDS defining condition in rural Uganda. Sex Transm Infect. Jun 2000;76(3):193-7. [Medline].

  88. Mori Y, Nishimoto N, Ohno M, et al. Human herpesvirus 8-encoded interleukin-6 homologue (viral IL-6) induces endogenous human IL-6 secretion. J Med Virol. Jul 2000;61(3):332-5. [Medline].

  89. Muralidhar S, Pumfery AM, Hassani M, et al. Identification of kaposin (open reading frame K12) as a human herpesvirus 8 (Kaposi's sarcoma-associated herpesvirus) transforming gene. J Virol. Jun 1998;72(6):4980-8. [Medline].

  90. Muralidhar S, Veytsmann G, Chandran B, Ablashi D, Doniger J, Rosenthal LJ. Characterization of the human herpesvirus 8 (Kaposi's sarcoma-associated herpesvirus) oncogene, kaposin (ORF K12). J Clin Virol. May 2000;16(3):203-13. [Medline].

  91. Nnoruka EN. Epidemic (human immunodeficiency virus-related) Kaposi's sarcoma in West African women. Int J Dermatol. Oct 2003;42(10):794-9. [Medline].

  92. Parra R, Leal M, Delgado J, et al. Regression of invasive AIDS-related Kaposi's sarcoma following antiretroviral therapy. Clin Infect Dis. Jan 1998;26(1):218-9. [Medline].

  93. Phillips JI, Sher R. Kaposi's sarcoma in different populations in South Africa. S Afr Med J. May 16 1987;71(10):615-9. [Medline].

  94. Portsmouth S, Stebbing J, Gill J, et al. A comparison of regimens based on non-nucleoside reverse transcriptase inhibitors or protease inhibitors in preventing Kaposi's sarcoma. AIDS. Jul 25 2003;17(11):F17-22. [Medline].

  95. Prakash O, Tang ZY, He YE, et al. Human Kaposi's sarcoma cell-mediated tumorigenesis in human immunodeficiency type 1 tat-expressing transgenic mice. J Natl Cancer Inst. May 3 2000;92(9):721-8. [Medline].

  96. Regamey N, Cathomas G, Schwager M, Wernli M, Harr T, Erb P. High human herpesvirus 8 seroprevalence in the homosexual population in Switzerland. J Clin Microbiol. Jun 1998;36(6):1784-6. [Medline].

  97. Rezza G, Tchangmena OB, Andreoni M, et al. Prevalence and risk factors for human herpesvirus 8 infection in northern Cameroon. Sex Transm Dis. Mar 2000;27(3):159-64. [Medline].

  98. Richter F, Hill GJ, Schwartz RA. Professor Kaposi's original concepts of Kaposi's sarcoma. J Cancer Educ. Summer 1995;10(2):113-6. [Medline].

  99. Rosella M, Masotti A, Cottoni F. Endoscopic examination in Kaposi's sarcoma. J Eur Acad Dermatol Venereol. May 2000;14(3):225-6. [Medline].

  100. Ruocco V, Sacerdoti G, Astarita C. Does quinine facilitate AIDS?. Antibiot Chemother. 1983;32:159-60. [Medline].

  101. Ruszczak Z, Mayer-Da Silva A, Orfanos CE. Kaposi's sarcoma in AIDS. Multicentric angioneoplasia in early skin lesions. Am J Dermatopathol. Oct 1987;9(5):388-98. [Medline].

  102. Ruszczak Z, Stadler R, Schwartz RA. Kaposi's sarcoma limited to penis treated with cobalt-60 radiotherapy. J Med. 1996;27(3-4):211-20. [Medline].

  103. Sapienza G, Nasca MR, Dinotta F, Micali G. Guess what. Classic Kaposi's sarcoma. Eur J Dermatol. Mar-Apr 2001;11(2):157-8. [Medline].

  104. Satta R, Cossu S, Massarelli G, Cottoni F. Anaplastic transformation of classic Kaposi's sarcoma: clinicopathological study of five cases. Br J Dermatol. Nov 2001;145(5):847-9. [Medline].

  105. Schneider I. To the hundredth anniversary of the death of Moriz Kaposi (1837-1902). Acta Microbiol Immunol Hung. 2002;49(4):501-6. [Medline].

  106. Schwartz RA. Kaposi's sarcoma. Ann Transplant. 1998;3(1):5-12. [Medline].

  107. Schwartz RA. Kaposi's sarcoma: advances and perspectives. J Am Acad Dermatol. May 1996;34(5 Pt 1):804-14. [Medline].

  108. Schwartz RA, Burgess GH, Hoshaw RA. Patch stage Kaposi's sarcoma. J Am Acad Dermatol. Jun 1980;2(6):509-12. [Medline].

  109. Schwartz RA, Gallardo MA, Kapila R, et al. Bacillary angiomatosis in an HIV seronegative patient on systemic steroid therapy. Br J Dermatol. Dec 1996;135(6):982-7. [Medline].

  110. Schwartz RA, Kardashian JF, McNutt NS, Crain WR, Welch KL, Choy SH. Cutaneous angiosarcoma resembling anaplastic Kaposi's sarcoma in a homosexual man. Cancer. Feb 15 1983;51(4):721-6. [Medline].

  111. Schwartz RA, Nychay SG, Janniger CK, Lambert WC. Bacillary angiomatosis: presentation of six patients, some with unusual features. Br J Dermatol. Jan 1997;136(1):60-5. [Medline].

  112. Schwartz RA, Spicer MS, Janniger CK, Cohen PJ, Melczer MM, Lambert WC. Keloidal Kaposi's sarcoma: report of three patients. Dermatology. 1994;189(3):271-4. [Medline].

  113. Schwartz RA, Spicer MS, Thomas I, Janniger CK, Lambert WC. Ecchymotic Kaposi's sarcoma. Cutis. Aug 1995;56(2):104-6. [Medline].

  114. Schwartz RA, Volpe JA, Lambert MW. Kaposi's sarcoma. Semin Dermatol. 1984;3:303-15.

  115. Sengupta SK, Edwards K, Blair A, Hamilton DR, Niblet JS. Childhood Kaposi's sarcoma in Papua New Guinea. Aust Paediatr J. Nov 1986;22(4):301-4. [Medline].

  116. Serraino D, Corona RM, Giuliani M, et al. Infection with human herpesvirus type 8 and kaposi's sarcoma in a central Italian area formerly endemic for malaria. Infection. Jan 2003;31(1):47-50. [Medline].

  117. Serwadda D, Carswell W, Ayuko WO, Wamukota W, Madda P, Downing RG. Further experience with Kaposi's sarcoma in Uganda. Br J Cancer. Apr 1986;53(4):497-500. [Medline].

  118. Serwin AB, Mysliwiec H, Wilder N, Schwartz RA, Chodynicka B. Three cases of classic Kaposi's sarcoma with different subtypes of Kaposi's sarcoma-associated herpesvirus. Int J Dermatol. Jul 2006;45(7):843-6. [Medline].

  119. Simonart T, Noel JC, De Clercq E, Snoeck R. Abatement of cutaneous Kaposi's sarcoma associated with cidofovir treatment. Clin Infect Dis. Dec 1998;27(6):1562. [Medline].

  120. Simonart T, Van Vooren JP, Herbauts J, Boelaert JR. High incidence of Kaposi's sarcoma in Iceland and the Faroe Islands. Br J Cancer. Jan 1999;79(2):373. [Medline].

  121. Snyder RA, Schwartz RA. Telangiectatic Kaposi's sarcoma. Occurrence in a patient with thymoma and myasthenia gravis receiving long-term immunosuppressive therapy. Arch Dermatol. Dec 1982;118(12):1020-1. [Medline].

  122. Stratigos JD, Katoulis AC, Stavrianeas NG. An overview of classic Kaposi's sarcoma in Greece. Adv Exp Med Biol. 1999;455:503-6. [Medline].

  123. Templeton AC. Kaposi's sarcoma. Pathol Annu. 1981;16:315-36. [Medline].

  124. Templeton AC, Bhana D. Prognosis in Kaposi's sarcoma. J Natl Cancer Inst. Dec 1975;55(6):1301-4. [Medline].

  125. Vander Straten MR, Carrasco D, Tyring SK. Treatment of human herpesvirus 8 infections. Dermatol Ther. 2000;13:277-84.

  126. Volberding PA. Kaposi's sarcoma and the acquired immunodeficiency syndrome. Med Clin North Am. May 1986;70(3):665-75. [Medline].

  127. Volberding PA. Moving towards a uniform staging for human immunodeficiency virus-associated Kaposi's sarcoma. J Clin Oncol. Sep 1989;7(9):1184-5. [Medline].

  128. Wabinga HR, Parkin DM, Wabwire-Mangen F, Nambooze S. Trends in cancer incidence in Kyadondo County, Uganda, 1960-1997. Br J Cancer. May 2000;82(9):1585-92. [Medline].

  129. Wilken JJ, Meier FA, Kornstein MJ. Kaposiform hemangioendothelioma of the thymus. Arch Pathol Lab Med. Oct 2000;124(10):1542-4. [Medline].

[ CLOSE WINDOW ]

Keywords

Kaposi sarcoma, Kaposi's sarcoma, multiple idiopathic hemorrhagic sarcoma, KS, KS-associated herpes virus, human herpesvirus type 8, HHV-8

[ CLOSE WINDOW ]

Contributor Information and Disclosures

Author

Robert A Schwartz, MD, MPH, Professor and Head, Dermatology, Professor of Pathology, Pediatrics, Medicine, and Preventive Medicine and Community Health, UMDNJ-New Jersey Medical School
Robert A Schwartz, MD, MPH is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American College of Physicians, and Sigma Xi
Disclosure: Nothing to disclose.

Coauthor(s)

W Clark Lambert, MD, PhD, Professor and Head, Dermatopathology, Departments of Pathology and Dermatology, UMDNJ-New Jersey Medical School
W Clark Lambert, MD, PhD is a member of the following medical societies: American Academy of Dermatology, American College of Physicians, American Dermatological Association, American Society of Dermatopathology, International Academy of Pathology, Medical Society of New Jersey, Sigma Xi, and Society for Investigative Dermatology
Disclosure: Nothing to disclose.

Medical Editor

Abby S Van Voorhees, MD, Assistant Professor, Director of Psoriasis Services and Phototherapy Units, Department of Dermatology, University of Pennsylvania School of Medicine, Hospital of the University of Pennsylvania
Abby S Van Voorhees, MD is a member of the following medical societies: American Academy of Dermatology, American Medical Association, National Psoriasis Foundation, Phi Beta Kappa, Sigma Xi, and Women's Dermatologic Society
Disclosure: Amgen Honoraria Consulting; Abbott Honoraria Consulting; Genentech Honoraria Consulting; Incyte Grant/research funds Other; Warner Chilcott Honoraria Consulting; Merck Salary Management position; Abbott  Speaking and teaching

Pharmacy Editor

Michael J Wells, MD, Associate Professor, Department of Dermatology, Texas Tech University Health Sciences Center
Michael J Wells, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American Medical Association, and Texas Medical Association
Disclosure: Nothing to disclose.

Managing Editor

Christen M Mowad, MD, Associate Professor, Department of Dermatology, Geisinger Medical Center
Christen M Mowad, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, and Phi Beta Kappa
Disclosure: Nothing to disclose.

CME Editor

Joel M Gelfand, MD, MSCE, Medical Director, Clinical Studies Unit, Assistant Professor, Department of Dermatology, Associate Scholar, Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania
Joel M Gelfand, MD, MSCE is a member of the following medical societies: Society for Investigative Dermatology
Disclosure: AMGEN Consulting fee Consulting; AMGEN Grant/research funds None; Genentech Consulting fee Consulting; Centocor Consulting fee Consulting; Centocor Grant/research funds None; Covance Consulting fee Consulting; Shire  Consulting

Chief Editor

Dirk M Elston, MD, Director, Department of Dermatology, Geisinger Medical Center
Dirk M Elston, MD is a member of the following medical societies: American Academy of Dermatology
Disclosure: Nothing to disclose.

 
 
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