CLINICAL MANIFESTATIONS: Cutaneous lesions can occur anywhere on the body and are usually brownish pink to deep purple. They characteristically present as lower-extremity skin lesions. Lesions may be flat or raised and surrounded by ecchymosis and edema; they develop rapidly and cause extensive disfigurement. The location and size of the lesions can lead to venous stasis, lymphedema, and pain.
COMMON SITES INVOLVED: Common sites of visceral involvement include the lymph nodes, gastrointestinal tract, and lungs. Involvement of internal organs may eventually lead to organ failure, hemorrhage, infection, and death.
ASSESSMENT AND DIAGNOSIS: Diagnosis is confirmed by biopsy of suspected lesions. Prognosis depends on extent of tumor, presence of other symptoms of HIV infection, and the CD4 count. Pathologic findings indicate that death occurs from tumor progression, but more often from other complications of HIV infection.
MEDICAL MANAGEMENT: Treatment goals are to reduce symptoms by decreasing the size of the skin lesions, to reduce discomfort associated with edema and ulcerations, and to control symptoms associated with mucosal or visceral involvement. No one treatment has been shown to improve survival rates. Radiation therapy is effective as a palliative measure to relieve localized pain due to tumor mass (especially in the legs) and for KS lesions that are in sites such as the oral mucosa, conjunctiva, face, and soles of the feet.
PHARMACOLOGICAL THERAPY: Patients with cutaneous KS treated with alpha-interferon have experienced tumor regression and improved immune system function. Alpha-interferon is administered by the intravenous (IV), intramuscular, or subcutaneous route. Patients may self-administer interferon at home or receive interferon in an outpatient setting. Nonsteroidal anti-inflammatory drugs (NSAIDs) and opioids are used as well.
RELATED;
1. INVASION OF HUMAN CD4 CELL BY HIV
2. HIV/AIDS
3. ANTIRETROVIRAL DRUGS (ARVs)
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