Extensive AIDS-associated Kaposi’s sarcoma

Abstract

Case description A 32-year-old Hispanic man presented with a long-term history of weight loss and progressive dermatosis and a 2-month history of occasional postprandial emesis after solid bolus intake. He referred to having had unprotected sex with multiple male partners and denied any other medical background or sexually transmitted disease. On physical examination, disseminated violaceous skin lesions were observed in patches (Figure 1A), as well as plaques and a right-ankle exophytic tumor (Figure 1B). During general workup, a fourth-generation HIV ELISA test was positive. His baseline HIV-1 RNA load was 760 000 copies/ml and CD4+ T-cell count was 93 cells/mm 3. A thoraco-abdominal and limb computed tomography (CT) scan revealed para-aortic lymphadenopathy and discarded lung and bone involvement. Biopsy of the ankle tumor was performed, showing positive immunohistochemical analysis results for human herpesvirus 8 Figure 1. Extensive Kaposi's sarcoma in an HIV-infected man. (A) Multiple violaceous dorsolumbar skin lesions; (B) right-ankle tumor and KS plaques; (C) gastroscopy: erythematous nodules in gastric body and fundus; (D) positive HHV-8 immunohistochemistry of gastric nodule biopsy.