[Cutaneous Kaposi disease disclosing acquired immunodeficiency syndrome in a child].

INTRODUCTION

Kaposi's sarcoma associated with acquired immunodeficiency syndrome is uncommon in children and cutaneous localizations are rare. We report a case of pediatric cutaneous Kaposi's sarcoma that revealed a human immunodeficiency virus infection.

OBSERVATION

An 8-years-old girl native of the Ivory Coast, with normal statural and psychomotor development, presented cutaneous Kaposi's sarcoma after varicella. The serodiagnosis was positive for type 1 human immunodeficiency virus and CD4 lymphocytes count was 9/mm3. A tonsil localization of Kaposi's sarcoma occurred and bleomycin was a short time effective. A relapse of cutaneous Kaposi's sarcoma with digestive, pulmonary and neurological symptoms was transitorily controlled by the association prednisone-vinblastine-doxorubicin, but death occurred with recurrence of pharyngeal Kaposi's sarcoma.

DISCUSSION

The review of literature shows that in pediatric acquired immunodeficiency syndrome, failure to thrive, encephalopathy and opportunistic infections are common. On the other hand, Kaposi's sarcoma is unusual and cutaneous localizations are especially observed when the contamination is postnatal and late. In our case the contamination is presumed perinatal and the human immunodeficiency virus infection was asymptomatic until 8 years old. Kaposi's sarcoma was the cause of the most presenting symptoms and of death, without demonstrated opportunistic infections.