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Kaposi's sarcoma in rheumatic diseases.

Worawit Louthrenoo1, Nuntana Kasitanon, Pongsak Mahanuphab

  • 1Division of Rheumatology, Department of Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand. wlouthre@mail.med.cmu.ac.th

Seminars in Arthritis and Rheumatism
|April 18, 2003
PubMed
Summary

Kaposi's sarcoma is rare in rheumatic disease patients, often linked to corticosteroid and immunosuppressive drug use. Lesions typically respond to treatment adjustments, though some cases are fatal.

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Area of Science:

  • Rheumatology
  • Oncology
  • Dermatology

Background:

  • Kaposi's sarcoma (KS) is a rare malignancy.
  • Its association with rheumatic diseases, particularly those treated with immunosuppressants, warrants investigation.

Observation:

  • A review of 25 reported cases of Kaposi's sarcoma in patients with rheumatic diseases (excluding HIV) was conducted.
  • Rheumatic conditions included rheumatoid arthritis, polymyositis/dermatomyositis, vasculitis syndromes, systemic lupus erythematosus, polymyalgia rheumatica, undifferentiated connective tissue disease, and Behcet disease.
  • Most patients had received long-term systemic corticosteroids and/or immunosuppressive drugs.

Findings:

  • Kaposi's sarcoma in this cohort presented similarly to classical KS, primarily affecting the skin of the extremities.

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  • Internal organ involvement was noted in 7 cases.
  • Tumor regression was observed with reduced corticosteroid/immunosuppressive dosages, radiation, or cytotoxic therapy.

    • Implications:

    • Kaposi's sarcoma is a rare but serious complication in patients with rheumatic diseases, often associated with immunosuppressive therapy.
    • Management involves adjusting immunosuppression, radiation, or chemotherapy.
    • Early recognition and treatment modification are crucial for patient outcomes.