Nodular Classic Kaposi's Sarcoma Treated With Neodymium-Doped Yttrium Aluminum Garnet Laser Delivered Through a Tilted Angle: Outcome and 12-Month Follow Up

ALA photodynamic therapy combined with dual 980nm/1470nm diode laser for classic Kaposi's sarcoma

A 84-year old man who has a history of refractory Kaposi's sarcoma (KS) was treated with ALA-PDT combined with the dual 980-nm/1470-nm diode laser for 6 times every other week. Satisfactory result was noted without any unbearable adverse effects. The combination of the dual 980nm/1470 nm diode laser and ALA-PDT may be astrategy in treating local KS with good tolerance, especially in elder patients who can not tolerate radiotherapy and chemotherapy.

Long-Pulsed Nd:YAG Laser for the Treatment of Classic Kaposi Sarcoma

Background: Classic Kaposi's sarcoma (CKS) is distinguished by nodules and clustered papules over the extremities with persistent edema. Aim: This report examine the results of neodymium-doped yttrium-aluminum-garnet (Nd:YAG) laser for the treatment of numerous nodular symptomatic nodules in CKS patients' lower extremities that are ineligible for systemic therapy. Methods: Each lesion received two sessions Nd:YAG laser treatment performed at 1-month intervals. Pretreatment and follow-up visit (after 3 months) were accompanied by clinical photographs and improvement was assessed by a skilled medical professional by comparing before- and after-treatment photos as well as by looking at patients directly. Videodermoscopy was performed on all lesions. Results: Just one session with long-pulsed Nd:YAG laser proved to be successful, with the immediate coagulation of the lesions and the disappearance of most of them. Every single lesion healed in two to 4 weeks. Only one lesion, the largest one, presented a water blister after treatment, which resolved within a few days. At 2 months follow up, the patient reported total pain relief and full recovery after the symptomatic nodules vanished. Conclusion: Nd:YAG laser could represent a rapid and advantageous therapeutic approach for both early- and advanced-stage CKS patients.

Kaposi's sarcoma: epidemiologic aspects, the immune reconstitution inflammatory syndrome, and more along the Silk Road of cognition

Kaposi's sarcoma remains enignmatic with many clinical and epidemiological patterns. We review them and describe the groove sign, an important association worthy of recognition. We also stress Kaposi's sarcoma (KS) without coexistent human immunodefiency virus infection, with recent data from China describing an extraordinarily high classical KS prevalence rate among Uygurs and Kazaks in the Xinjiang Uygur Autonomous Region in northwestern China, presumably derived from elderly men residing there. The possible travel of HHV-8 along the ancient silk road from Italy to the Xinjiang Uyghur region remains intriguing. If only one in 10,000 HHV-8-infected patients develops classical KS worldwide, then triggers for its overrepresentation in this population within China are of particular concern. The KS-related immune reconstitution inflammatory syndrome is also emphasized.

Kaposi's Sarcoma Management from a Plastic Surgery Perspective

Kaposi's Sarcoma (KS) is a low-grade angioproliferative tumor arising from endothelial cells and associated with Human Herpes Virus 8 infection. Although KS cases are not rare and there are considerable number of patients referred for surgical excision, the plastic surgery literature on KS is exceptionally scarce. Thirty patients who were operated with the diagnosis of KS between March 2015 and January 2020 were included. Preoperative HIV tests and detailed whole-body examinations of the patients were performed. As a surgical method, for lesions with sizes ranging from 0.5 * 1 cm to 2 * 3 cm, excisions were made over the deep skin fascia by placing a margin between 0.5-1 cm, considering the anatomical location and elasticity of the skin. Primary repair was performed in 40 lesions and 12 lesions of 8 patients were repaired with a skin graft. In four patients the repair was performed with local skin flaps. Higher upper extremity involvement, less systemic involvement and less pronounced male predominance have been important results in our study that we have found different from the literature data. Compared to the therapies such as radiotherapy, laser, or chemotherapy which require several administrations; one-stage surgical excision of the lesions provides remarkable advantages.

Effectiveness and Safety of Treatment with Neodymium:YAG Laser 1064 nm in Patients with Classic and Epidemic Kaposi Sarcoma

Kaposi’s sarcoma (KS) is a vascular neoplasm Herpes Virus 8 (HHV8), which can affect the skin, mucous membranes and viscera. There is currently no standard treatment for KS; this study evaluated the efficacy and safety of Neodymium:YAG (Nd:YAG) laser 1064 nm treatment in patients with classic and HIV-associated KS. 15 patients with classic KS (group A) and 15 with epidemic KS (group B), with exclusively cutaneous localization, were treated with Nd:YAG laser 1064 nm. Four treatment sessions were performed at 4 weeks intervals. 24/30 (80%) of treated patients underwent clinical improvement. Better results have been obtained in HIV-positive patients, especially in terms of reduced lesion size and the flattening of elevated lesions. The 1064 nm Nd:YAG laser is effective and safe in the treatment of classic and epidemic KS, especially in patients with symptomatic, slow-progressing local disease, where other treatment options may be inappropriate.

Diagnosis and treatment of classic and iatrogenic Kaposi's sarcoma: Italian recommendations

Kaposi's sarcoma (KS) is a lymphangioproliferative disorder associated with Human herpesvirus 8 (HHV8) infection. Four clinical subtypes are recognized: classic, endemic, epidemic (HIV-related) and iatrogenic. KS diagnosis is based on clinical features, histopathological assessment, and HHV8 serology. Classic KS is usually skin-limited and has a chronic course, while the iatrogenic variant may show mucosal, nodal or visceral involvement. Clinical staging is fundamental to guide the management. Localized disease may be treated with different local therapies, even if there are no randomized trials comparing these different modalities. Aggressive, disseminated KS and cases with visceral involvement usually require systemic chemotherapy, most commonly vinblastine, bleomycin or paclitaxel. Iatrogenic KS needs immunosuppression tapering/withdrawal and, if possible, switch to m-TOR inhibitors in post-transplant KS. The present work by a panel of Italian experts provides guidelines on KS diagnosis and management based on a critical review of the literature and a long and extensive personal experience.