Department of Dermatology, The Affiliated Hospital, Guizhou Medical University, Beijing Road 4, Yunyan District, Guiyang, China.
Department of Dermatology, The Affiliated Hospital, XingJiang Medical University, Urumqi, China.
J Med Case Rep. 2021 Apr 19;15(1):179. doi: 10.1186/s13256-021-02777-7.
Classic Kaposi sarcoma (CKS) is a vascular sarcoma associated with human herpesvirus 8 (HHV-8), which is known to be more common in Mediterranean elderly men and is characterized by indolent clinical behavior. Xinjiang province in China is considered an endemic region for Kaposi's sarcoma-associated herpesvirus (KSHV), with higher incidence among adults of Kazak and Uyghur ethnicities. Cases of CKS are rarely reported in inland China. Here, we followed a case of CKS for 7 years in a patient of Miao ethnic background in southwestern China.
A 63-year-old Miao (southwestern China) man was initially diagnosed with CKS in 2010, having a history of limb lesions for 37 years, with left eyelid and binaural lesions for 9 years. He did not have sexual contact with men and was human immunodeficiency virus (HIV)-negative. Due to his lumbago and fever, spinal tuberculosis in the lumbar vertebra was highly suspected after computed tomography (CT) scan. However, diagnostic antituberculosis treatment for 4 weeks failed. The patient was followed up in 2016, when the rash was recovering as the systemic symptoms improved. A new CT was performed, which showed a partial response despite the absence of any medical treatment. The open reading frame (ORF)-K1 of KSHV from skin tissue of the foot was amplified and sequenced, and K1 belonged to subtype A. This genotype is consistent with the typical subtype present in Xinjiang.
We describe spontaneous partial regression of CKS in a patient of Miao ethnicity in inland China. Our sample may represent an unknown, novel genotype. Surveillance and regulating the immune state may represent a valuable approach for this rare disease.
经典卡波西肉瘤（CKS）是一种与人类疱疹病毒 8 （HHV-8）相关的血管肉瘤，已知在地中海老年男性中更为常见，其临床行为表现为惰性。中国新疆被认为是卡波西肉瘤相关疱疹病毒（KSHV）的流行地区，哈萨克族和维吾尔族成年人的发病率较高。在中国内陆，CKS 病例很少见。在这里，我们对一名来自中国西南部苗族背景的患者进行了 7 年的 CKS 随访。
一名 63 岁的苗族（中国西南部）男子于 2010 年最初被诊断为 CKS，他的下肢病变病史已有 37 年，左眼睑和双耳病变病史已有 9 年。他没有与男性发生过性接触，且人类免疫缺陷病毒（HIV）阴性。由于腰痛和发热，CT 扫描高度怀疑他患有腰椎脊椎结核。然而，抗结核诊断性治疗 4 周后未见疗效。2016 年，该患者接受了随访，此时皮疹随着全身症状的改善而恢复。尽管没有任何治疗，新的 CT 显示出部分反应。从足部皮肤组织中扩增和测序了 KSHV 的开放阅读框（ORF）-K1，K1 属于 A 亚型。这种基因型与新疆的典型亚型一致。
我们描述了一名中国内陆苗族患者的 CKS 自发性部分消退。我们的样本可能代表了一种未知的新型基因型。监测和调节免疫状态可能是治疗这种罕见疾病的一种有价值的方法。
