Imiquimod for the treatment of classical Kaposi's sarcoma.

© 2010 The Authors. doi: 10.2340/00015555-0850 Journal Compilation © 2010 Acta Dermato-Venereologica. ISSN 0001-5555 Kaposi’s sarcoma (KS) is a multifocal neoplasm of the endothelium. It is typically associated with human herpesvirus 8 (HHV-8). This neoplasm is observed in immunocompromised patient populations and in elderly people from specific geographical areas. KS lesions are nodules or patches that may be red, purple, brown or black, and are usually papular. They are typically found on the skin (lower limbs, face, mouth and genitalia), but may spread elsewhere, especially the mouth, gastrointestinal tract and respiratory tract. The virus can be detected in the neoplastic spindle cells characteristic of KS lesions, and in circulating mononuclear cells (mostly B lymphocytes and monocytes). Four clinical groups of KS have been identified: classical KS in older people of Eastern European or Jewish origin, endemic KS in indigenous Africans, and AIDS-related (or epidemic) and non-AIDS-related KS related to immunosuppression. Rapid, progressive, systemic, or life-threatening KS requires systemic treatments such as bleomycin, vinblastine, liposomal doxorubicin, paclitaxel, docetaxel, or interferon-alpha. For localized lesions several skin-directed therapies have been proposed, notably radio therapy, cryotherapy, intralesional vinblastine, intralesional interferon and laser ablation (1). We report here a case of localized KS that was treated successfully with the immune response modifier imiquimod.