Aids Related Kaposi’s Sarcoma: Report of Two Libyan Patients and Review of the Literature

Abstract

Kaposi Sarcoma is a vascular proliferation characterised by mucocutaneous violaceous lesions and oedema, as well as involvement of nearly any organ. Any mucocutaneous surface may be involved, but areas of predilection include the hard palate, trunk, penis, lower legs, and soles. Recent work has clearly identified human herpes-8 virus-like DNA sequences in Kaposi’s sarcoma, both those with and without additional HIV infection. It is much more common in homosexuals than in others at risk, such as drug abusers or haemophiliacs. HIV-Associated KS was first recognized in 1979, when an epidemic of Kaposi’s sarcoma was identified in the homosexual community in New York. It is usually developed in the later stages of the disease and is rarely a presenting feature of HIV infection. It is an aggressive form of the disease, with a median survival of 18 months if left untreated. Since the introduction of anti-retroviral therapy (ART), there has been a marked decrease in morbidity and mortality. For patient with symptomatic visceral diseases, aggressive skin disease, marked oedema and pulmonary disease, systemic chemotherapy is indicated We report two Libyan patients of extensive Kaposi sarcoma and AIDS: A 32 years-old male with CD4 count of 394 cells/ml and A 45 years-old male, drug abuser with CD4 count of 116 cells/ml, who were admitted in our department with multiple, asymptomatic, papulo-nodular lesion scattered over upper, lower extremities, trunk, and perianal and mouth mainly the palate and gums.   To the best of our knowledge, these are the first two cases of extensive KS involving the skin and mucous membranes reported by the dermatology department at Tripoli Central Hospital.