Kaposi’s sarcoma symmetric mucosal lesions

Abstract

A 31-year-old man presented with symmetrical purple lesions on the mucosal surfaces of his lower eyelids. A careful anamnesis revealed risk factors for sexually transmitted diseases. On physical examination, similar lesions were noticed on his pharynx and left leg. Testing for human immunodeficiency virus (HIV) antibodies was positive. Human herpesvirus 8 serology was positive and a cutaneous biopsy of the lesions confirmed the diagnosis of mucocutaneous Kaposi’s sarcoma. Chest X-ray, echocardiography, and colonoscopy were negative. Kaposi’s sarcoma remains the second most frequent neoplasm in HIV-infected patients worldwide, and can represent the first clinical manifestation in newly diagnosed HIV infection [1]. Our patient refused any treatment and, 2 months later, developed a lymphoproliferative disorder (Castleman’s disease); then, he accepted to begin highly active antiretroviral treatment plus chemotherapy. Two years of follow-up, including clinical and radiological investigation, did not evidence any progression of Castleman’s disease. In conclusion, in patients with risk factors for HIV infection, reddish conjunctival mucosal lesions should prompt careful diagnostic investigation for Kaposi’s sarcoma [2].