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Minerva

Cutaneous Kaposi’s sarcoma

BMJ 2021; 373 doi: https://doi.org/10.1136/bmj.n926 (Published 05 May 2021) Cite this as: BMJ 2021;373:n926
  1. Yun Liu, resident,
  2. Lindi Jiang, professor
  1. Department of Rheumatology, Zhongshan Hospital, Fudan University, Shanghai, China
  1. Correspondence to: L Jiang, jiang.lindi{at}zs-hospital.sh.cn

This is iatrogenic Kaposi’s sarcoma associated with human herpesvirus 8 on the leg of a woman in her 60s (fig 1).

One year earlier she had received a diagnosis of dermatomyositis, an autoimmune inflammatory myopathy. She was treated with prednisolone and cyclosporin. During treatment she presented with extensive, raised, firm, purple-black nodules on her face, chest, back, and limbs. Scaling and necrosis were seen on macro lens (a magnifying lens used for dermatological photography). The test result for HIV was negative and no evidence of visceral involvement was observed on imaging. Skin biopsy and immunohistochemical staining confirmed a diagnosis of Kaposi’s sarcoma.

Iatrogenic Kaposi’s sarcoma caused by immunosuppressants occurs because of weakened immunological surveillance, which reactivates latent human herpesvirus 8 infection and contributes to the proliferative transformation and angiogenic properties of the infected endothelial cells. Kaposi’s sarcoma should be considered in people with immunosuppression who present with such a rash.

Footnotes

  • Competing interests: None declared.

  • Patient consent obtained.

  • Provenance and peer review: Not commissioned; externally peer reviewed.