Ruffion N, Frappaz D, Philippot V, Floret D, Perrot H
Service de Dermatologie, Hôpital de l'Antiquaille, Lyon.
Ann Dermatol Venereol. 1997;124(4):318-21.
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.
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.
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.
与获得性免疫缺陷综合征相关的卡波西肉瘤在儿童中并不常见，皮肤定位也很罕见。我们报告一例小儿皮肤卡波西肉瘤病例，该病例揭示了人类免疫缺陷病毒感染。
一名来自象牙海岸的8岁女孩，身高和精神运动发育正常，在水痘后出现皮肤卡波西肉瘤。血清学诊断显示1型人类免疫缺陷病毒呈阳性，CD4淋巴细胞计数为9/mm³。出现了扁桃体卡波西肉瘤，博来霉素短期内有效。皮肤卡波西肉瘤复发并伴有消化、肺部和神经症状，泼尼松-长春碱-阿霉素联合治疗暂时控制了病情，但最终因咽部卡波西肉瘤复发而死亡。
文献回顾表明，在小儿获得性免疫缺陷综合征中，生长发育迟缓、脑病和机会性感染很常见。另一方面，卡波西肉瘤并不常见，尤其是在出生后和晚期感染时才会出现皮肤定位。在我们的病例中，推测感染发生在围产期，人类免疫缺陷病毒感染直到8岁时都没有症状。卡波西肉瘤是最主要症状和死亡的原因，未发现机会性感染。
