Diagnostic implications of genital Kaposi's sarcoma

Genital Kaposi's sarcoma (KS) before the AIDS epidemic was rarely seen in Uganda although a case was seen in 1973, 1982, 1983 and 1985. Eight cases were seen in 1986 and another 17 cases have been documented since the beginning of 1987. Of the 29 patients, 23 were males, 6 females (M:F = 3.8:1); median age 29 years (range 7-70 years). All except 8 males were under 40 years. Six patients had pure nodular disease, while the rest had mixed clinical type. The external genitalia was involved in nodular disease in 15 patients, 12 had infiltrative disease and 6 had ulcerative disease. Florid and plaque were seen in one case each. Mixed cellularity was typed in 13 patients. 19(70.4%) were positive for HIV serology (ELISA Wellcome kit) of whom 13(61.9%) were males. All females were positive. The patient who presented in 1973 remains alive and disease free 13.5 years making it unlikely that he had AIDS. It appears therefore that genital KS is a feature of HIV associated KS and this mode of presentation is new in Uganda.