Treatment of oral Kaposi's sarcoma with a sclerosing agent in AIDS patients. A preliminary study

Presently oral Kaposi's sarcoma is primarily treated with systemic and intralesional chemotherapy, immunotherapy, radiation, and occasionally lasers. Each of these modalities achieves varying degrees of success. In patients with acquired immunodeficiency syndrome, the traditional treatments are frequently accompanied by local and generalized side effects that are detrimental to an already compromised immune system. Experience using sclerosing agents to treat other oral vascular lesions in healthy patients is known to produce excellent results. To evaluate the use of this treatment method in patients with acquired immunodeficiency syndrome, 15 oral lesions in 12 patients were injected with 3% sodium tetradecyl sulfate (Sotradecol). Thirteen lesions were located on hard palate; nine were nodular, three papular, and three macular. One week after treatment, some degree of ulceration occurred in all lesions with healing beginning by the middle of the second week. Six lesions required a second treatment to completely resolve. In one patient, healing was delayed, and the patient encountered a period of discomfort as a result of superficial bone sequestration. All other lesions healed uneventfully without the major side effects encountered with the other commonly used methods. Patients were followed for recurrence until they died or moved away. No recurrences were noted, with many followed for 18 months or longer. It is suggested that for lesions 2.6 cm or less in size, a sclerosing agent may be a better treatment modality than those now commonly used for oral Kaposi's sarcoma.