Kaposi's Sarcoma

00:01 Next up, we shall talk about Kaposi’s sarcoma.

00:05 Now, Kaposi’s sarcoma, you may automatically think about HIV when you hear that diagnosis.

00:10 But it turns out there's a couple of different causes for this one.

00:13 It is angioproliferative malignant tumor arising from vascular endothelium.

00:19 It is very commonly associated with HIV and human herpes virus 8.

00:25 But there are actually four different sub-types that give rise to this condition.

00:29 The first one is epidemic sub-type which is the AIDS-associated one that we're very familiar with.

00:34 That was one of the harbingers of HIV AIDS during the AIDS epidemic in the United States in the 80s.

00:42 But it turns out there are some other causes as well.

00:44 There's iatrogenic and this is a variety that we still sometimes see today in patients who are on immunosuppressive medications and perhaps transplant patients.

00:54 You have to keep an eye out for these types of lesions in those patients.

00:58 There's an endemic variety, which is endemic to indigenous Africans and is generally only seen in those areas.

01:07 Then a classic version, which interestingly enough is one of the least common varieties but it was referred to as classic Kaposi’s sarcoma before it became associated with the HIV AIDS epidemic and it’s seen in older, white men.

01:21 You can see the lesions depicted here.

01:23 They're violaceous and colored.

01:25 They can be flat but they may also be papular.

01:28 You'll see them in a variety of locations.

01:30 You're not looking for them in skin-exposed areas.

01:32 It's also important to remember that they can have mucosal involvement.

01:36 It's strongly linked to the CD4 count.

01:38 The lower your CD4 count, the more likely these lesions are to emerge.

01:43 I've described the features of the lesions themselves commonly associated with the legs though you may see them on the face, the oral mucosa and genitalia.

01:53 Importantly, you may have some visceral involvement particularly of the GI tract with this condition as well.

02:00 Either way, that doesn't really fit in with our patient as well.

02:03 We're not getting any of those risk factors in the patient's history.

02:08 I think we can safely take that fairly rare cancer off of our list.