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Updated: Sep 26, 2026

Identifying Dysregulated Genes Induced by Kaposi's Sarcoma-associated Herpesvirus (KSHV)
Published on: September 14, 2010
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
Objective:
To review the clinical features and outcome of all reported cases of Kaposi's sarcoma in patients with rheumatic diseases.
Methods:
In addition to our patient, we identified cases from a Medline search between the years 1966 and 2002. Cases associated with human immunodeficiency virus infection were excluded.
Results:
Including our patient, there were a total of 25 cases reported (11 men and 14 women). Rheumatoid arthritis was present in 8 cases, polymyositis/dermatomyositis in 5, vasculitis syndromes in 5, systemic lupus erythematosus in 3, polymyalgia rheumatica in 2, and 1 each of undifferentiated connective tissue disease and Behcet disease. All but 1 patient had been given systemic corticosteroids for a duration that ranged from 6 weeks to 22 years, and immunosuppressive drugs from 25 days to 3.5 years. The Kaposi's lesions usually involved the skin on the extremities; internal organ involvement occurred in 7 cases. Most lesions responded to a decreasing dosage of corticosteroids and immunosuppressive drugs, or to the administration of radiation or cytotoxic therapy. Six patients died, 4 of which were related to the progression of Kaposi's sarcoma.
Conclusion:
Kaposi's sarcoma in patients with rheumatologic conditions is rare. The clinical features are similar to those with classical Kaposi's sarcoma. Tumor regression usually occurs with decreasing corticosteroids and/or immunosuppressive drugs, local irradiation, or cytotoxic therapy.
Insights
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.
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.
- 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.
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