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Kaposi's Sarcoma—a Review of 22 Cases in NCKUH from 1988 to 1998—
Tzu-Kai Lin, J. Yu-Yun Lee, Sheau-Choiu Chao, Li-Lin Liu, Mark Ming-Long Hsu
Dermatol Sinica 19: 190-198, 2001

Kaposi's sarcoma (KS) is no longer considered a rare disease in Taiwan, there have been only scattered case reports. In this retrospective study, we review all patients with pathology-proven KS diagnosed at Department of Dermatology, National Cheng Kung University Hospital from 1988 to 1998, and report the epidemiology, clinical presentation, treatment and prognosis of this malignancy. The present series consists of 22 patients of KS, including 20 males and 2 females, aged between 25 and 80 years. There were 9 classic KS, 7 iatrogenic immunosuppression-related KS, and 6 AIDS-related KS. KS from ten of the 22 patients were analyzed for the presence of HHV-8 sequence by polymerase chain reaction. The results revealed that all 10 cases of KS, including all 3 types, were positive for the HHV-8. Of the iatrogenic group, 4 had history of chronic herb drug (often containing corticosteroids) use which constitutes a common form of steroid abuse in Taiwan. Three of these 4 patients manifested generalized dermatophytosis. Compared with classical KS, KS in these group has higher tendency to involve truncal parts, although their CD4+ lymphocyte counts were still within normal range. Compared with the non-AIDS KS groups, AIDS-KS group showed younger age at onset (38.5 yr vs 64.1 yr), more widespread skin lesions (100% vs 44%), and frequent involvement of the head and neck (83% vs 0%), and oral mucosa (67% vs 0%), lower CD4+ lymphocyte counts (16/mm3 vs 431/mm3), and poorer response to treatment. Extracutaneous lesions were only seen in AIDS patients, involving oral mucosa in 4 patients, pulmonary in 2 and GI tract in 1. In general, limited disease in the present series responded to local treatment while generalized or aggressive disease required systemic treatment. In 2 non-AIDS patients and 1 AIDS patient, chemotherapy with paclitaxel (taxol) was effective.

   
   
 
 
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