Clinical observations of skin Kaposi’s sarcoma

Kaposi's sarcoma is an angioproliferative disease of endothelial origin associated with human herpes virus-8 (HHV-8), or Kaposi's sarcoma herpesvirus. The disease was first described in 1872 by Moritz Kaposi as a pigmented cutaneous sarcoma localized on the lower extremities.

The disease is considered quite rare, but at present there is an increase in the incidence worldwide, due to which there is a growing interest in this problem. Today, it remains the leading skin pathology among HIV-positive patients, occurring in 20%. However, the assessment of the pathological process can be difficult, and the diagnosis may not be made at all, due to atypical clinical manifestations (especially in HIV-negative patients), so the problem of Kaposi's sarcoma diagnostics remains relevant for doctors of any specialty, especially dermatovenerologists and oncologists.

Kaposi's sarcoma can affect almost any organ, including the skin. The most common localization is on the skin of the extremities and face. Clinical manifestations are rashes in the form of spots, nodules, plaques, nodes. Kaposi's sarcoma is classified according to clinical and epidemiological forms: classical, endemic, epidemic and iatrogenic. Recently, a fifth form has been described, called non-epidemic Kaposi's sarcoma, which is observed in HIV-negative men who have sex with other men.

The persistence of HHV-8 alone in the human body is not sufficient for Kaposi's sarcoma to occur, as the development of the disease is dependent on immunosuppressive conditions such as HIV infection, cytostatic drugs, and chronic systemic inflammatory diseases (e.g., rheumatoid arthritis). The interaction between human immune dysfunction and the local inflammatory response to herpesvirus creates a favourable environment for the onset and progression of the disease.

These clinical cases demonstrate an atypical clinical course of Kaposi's sarcoma of the skin with the absence of HIV-1, HIV-2 and HHV-8 in the blood of the presented patients.