Wall Dmitri, McMenamin Mairín, O'Mahony Deirdre, Irvine Alan D
Department of Dermatology, St James's Hospital, Dublin, Ireland.
BMJ Case Rep. 2013 Nov 21;2013:bcr2013202171. doi: 10.1136/bcr-2013-202171.
There are four clinical subtypes of Kaposi sarcoma (KS): classic, endemic, epidemic and iatrogenic. The geographical prevalence of the endemic variant matches areas of human herpes virus type 8 (HHV8) seroprevalence. The iatrogenic variant, seen in immunosuppressed patients, can be associated with significant morbidity and mortality. This is the first report of KS described in the context of atopic dermatitis (AD) treated with ciclosporin (CSA). We report a case of KS in an HHV8 seropositive Congolese patient following immunosuppression with CSA for AD. Treatment has been challenging, protracted and associated with significant morbidity. Immunosuppressive therapies are increasingly used for inflammatory dermatological conditions, including AD. This case highlights the importance of HHV8 screening of patients from endemic regions or those with other risk factors. It also highlights the importance of early recognition of a condition associated with significant morbidity and even mortality to facilitate appropriate treatment.
卡波西肉瘤(KS)有四种临床亚型:经典型、地方性、流行性和医源性。地方性变种的地理分布与人类疱疹病毒8型(HHV8)血清阳性率的地区相匹配。医源性变种见于免疫抑制患者,可导致显著的发病率和死亡率。这是在使用环孢素(CSA)治疗特应性皮炎(AD)的背景下描述KS的首例报告。我们报告了1例HHV8血清阳性的刚果患者在使用CSA免疫抑制治疗AD后发生KS的病例。治疗具有挑战性、病程漫长且伴有显著的发病率。免疫抑制疗法越来越多地用于包括AD在内的炎症性皮肤病。该病例强调了对来自流行地区或有其他危险因素的患者进行HHV8筛查的重要性。它还强调了早期识别与显著发病率甚至死亡率相关的疾病以促进适当治疗的重要性。