Kaposi’s sarcoma: four main forms
Kaposi’s sarcoma is a rare form of skin cancer that can also affect mucous membranes and internal organs. The tumor disease can occur in several places at the same time. The skin changes typically begin as reddish-brown to purple patches. These can develop into extensive plaques or hard nodules.
The course of Kaposi’s sarcoma can vary greatly. The tissue changes can remain fairly constant or spread within a short period of time and lead to death (especially in HIV patients). Doctors distinguish between four main forms of Kaposi’s sarcoma:
HIV-associated (epidemic) Kaposi’s sarcoma
HIV-associated Kaposi’s sarcoma can be both an early sign of an HIV infection and a late symptom in the course of the AIDS disease when the immune system is severely weakened. It can affect the skin, mucous membranes and practically all internal organs (gastrointestinal tract, heart, liver, lungs, etc.). Organ involvement can quickly become life-threatening.
Kaposi’s sarcoma due to iatrogenic suppression of the immune system
In some cases, people’s immune systems have to be suppressed with medication. This is necessary, for example, after an organ transplant and in the treatment of some chronic inflammatory diseases. This suppression of the immune system (immunosuppression) by medical measures is known as “iatrogenic”.
The weakened immune system of those affected favors the development of Kaposi’s sarcoma (as in HIV patients). As soon as immunosuppression is discontinued, it sometimes regresses completely.
Classic Kaposi’s sarcoma
Classic Kaposi’s sarcoma mainly affects older men (in their seventh decade of life) who come from Eastern Europe or the Mediterranean region or are of Jewish origin. The typical skin changes mainly develop on the legs. They usually progress slowly over years or decades. Internal organs are rarely affected. Classic Kaposi’s sarcoma is therefore not particularly aggressive.
Endemic Kaposi’s sarcoma
Endemic Kaposi’s sarcoma occurs in Africa south of the Sahara (sub-Saharan region). It can occur in four variants, for example as a relatively benign form that is associated with skin nodules and resembles classic Kaposi’s sarcoma. It mainly affects men around the age of 35.
Kaposi’s sarcoma: Therapy
There is as yet no generally recognized therapy regimen for the treatment of Kaposi’s sarcoma. Here are some examples of treatment options:
In patients with HIV-associated (epidemic) Kaposi’s sarcoma, effective antiretroviral therapy is the most important treatment measure. If this is not sufficient to prevent the spread of Kaposi’s sarcoma, chemotherapy may be considered.
If the tumor is the result of immunocompromising medication, it should be checked to what extent these can be reduced or discontinued altogether. The tumor foci then usually regress completely.
Endemic Kaposi’s sarcoma usually responds well to anti-cancer drugs.
Classic Kaposi’s sarcoma is usually only treated locally, mainly with radiotherapy. Other therapies may also be considered, such as cold therapy (cryotherapy) or chemotherapy.
Aftercare
Kaposi’s syndrome is prone to relapse (recurrence). Patients should therefore visit their doctor for regular check-ups after treatment has been completed.
