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__NOTOC__
__NOTOC__
{{CMG}}
 
{{CMG}} {{AE}} {{HL}} {{Hudakarman}}
{{Kaposi's sarcoma}}
{{Kaposi's sarcoma}}


==Overview==
Kaposi's sarcoma may be classified according to the clinical setting of the [[disease]] into five subtypes include Classic Kaposi's sarcoma, African [[cutaneous]] Kaposi's sarcoma, African [[Lymphadenopathy|lymphadenopathic]] Kaposi's sarcoma, [[Immunosuppression]]-associated Kaposi's sarcoma, and [[AIDS]]-associated Kaposi's sarcoma.
==Classification==
==Classification==
HHV-8 is responsible for all varieties of KS. Since Moritz Kaposi first described this malignant neoplasm, the disease has been reported in five separate clinical settings, with different presentations, [[epidemiology]], and prognoses<ref name="Andrews">James, William; Berger, Timothy; Elston, Dirk (2005). ''Andrews' Diseases of the Skin: Clinical Dermatology''. (10th ed.). Saunders. ISBN 0-7216-2921-0.</ref>{{Rp|599}}. All of these forms are infected with [[Kaposi's sarcoma-associated herpesvirus|KSHV]] and are different manifestations of the same disease but have differences in clinical aggressiveness, prognosis and treatment.
*<nowiki/>According to the clinical setting of the [[disease]], clinical presentation, [[epidemiology]], and [[prognosis]] Kaposi's sarcoma may be classified into five different subtypes<ref name="pmid21377267">{{cite journal |vauthors=Uldrick TS, Whitby D |title=Update on KSHV epidemiology, Kaposi Sarcoma pathogenesis, and treatment of Kaposi Sarcoma |journal=Cancer Lett. |volume=305 |issue=2 |pages=150–62 |date=June 2011 |pmid=21377267 |doi=10.1016/j.canlet.2011.02.006 |url=}}</ref><ref name="pmid6861160">{{cite journal |vauthors=Krigel RL, Laubenstein LJ, Muggia FM |title=Kaposi's sarcoma: a new staging classification |journal=Cancer Treat Rep |volume=67 |issue=6 |pages=531–4 |date=June 1983 |pmid=6861160 |doi= |url=}}</ref><ref name="pmid18655700">{{cite journal |vauthors=Grayson W, Pantanowitz L |title=Histological variants of cutaneous Kaposi sarcoma |journal=Diagn Pathol |volume=3 |issue= |pages=31 |date=July 2008 |pmid=18655700 |pmc=2526984 |doi=10.1186/1746-1596-3-31 |url=}}</ref>
*<nowiki/>African [[cutaneous]] Kaposi's sarcoma and African [[Lymphadenopathy|lymphadenopathic]] Kaposi's sarcoma could be classified under the term of [[endemic]] Kaposi's sarcomas.
 
{| style="border: 0px; font-size: 90%; margin: 3px;" align="center"
! rowspan="1" style="background: #4479BA; padding: 5px 5px;" |{{fontcolor|#FFFFFF|Types}}
! rowspan="1" style="background: #4479BA; padding: 5px 5px;" |{{fontcolor|#FFFFFF|Characteristics}}
|-
| rowspan="1;" style="padding: 5px 5px; background: #DCDCDC; font-weight: bold;" |Classic (Mediterranean) Kaposi's sarcoma <ref name="pmid25889316">{{cite journal| author=Vincenzi B, D'Onofrio L, Frezza AM, Grasso RF, Fausti V, Santini D et al.| title=Classic Kaposi Sarcoma: to treat or not to treat? | journal=BMC Res Notes | year= 2015 | volume= 8 | issue=  | pages= 138 | pmid=25889316 | doi=10.1186/s13104-015-1076-1 | pmc=4395989 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25889316  }}</ref><ref name="StratigosPotouridou1997">{{cite journal|last1=Stratigos|first1=John|last2=Potouridou|first2=Irene|last3=Katoulis|first3=Alexander|last4=Hatziolou|first4=Eftichia|last5=Christofidou|first5=Eleftheria|last6=Stratigos|first6=Alexander|last7=Hatzakis|first7=Angelos|last8=Stavrianeas|first8=Nicholas|title=Classic Kaposi's sarcoma in Greece: a clinico-epidemiological profile|journal=International Journal of Dermatology|volume=36|issue=10|year=1997|pages=735–740|issn=0011-9059|doi=10.1046/j.1365-4362.1997.00284.x}}</ref><ref name="pmid11489800">{{cite journal| author=Landau HJ, Poiesz BJ, Dube S, Bogart JA, Weiner LB, Souid AK| title=Classic Kaposi's sarcoma associated with human herpesvirus 8 infection in a 13-year-old male: a case report. | journal=Clin Cancer Res | year= 2001 | volume= 7 | issue= 8 | pages= 2263-8 | pmid=11489800 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11489800  }}</ref><ref name="CetinAktas2018">{{cite journal|last1=Cetin|first1=Bulent|last2=Aktas|first2=Bilge|last3=Bal|first3=Oznur|last4=Algin|first4=Efnan|last5=Akman|first5=Tulay|last6=Koral|first6=Lokman|last7=Kaplan|first7=Mehmet Ali|last8=Demirci|first8=Umut|last9=Uncu|first9=Dogan|last10=Ozet|first10=Ahmet|title=Classic Kaposi's sarcoma: A review of 156 cases|journal=Dermatologica Sinica|volume=36|issue=4|year=2018|pages=185–189|issn=10278117|doi=10.1016/j.dsi.2018.06.005}}</ref>
| style="padding: 5px 5px; background: #F5F5F5;" |
*[[Vascular]] sarcoma
* Common in Mediterranean [[elderly]] [[men]]
*Indolent [[clinical]] [[behavior]]
*Pigmented [[macular]]–[[Papule|papular]] lesions on [[mucocutaneous]] surface
*Typically appears as dark [[blue]] or purple
*[[Lesions]] may present as [[solitary]] [[nodules]] or [[plaques]] and [[tumors]] to a size of several centimeters
*Usually, present in the [[skin]] of the [[lower extremities]] and progresses very slowly
*[[Mucous membranes]] of the [[mouth]] and [[GI]] tract and regional [[lymph nodes]] could be affected
*Factors that affect the selection of local [[therapy]] are:
**The extent and location of the [[lesions]]
**The rapidity of [[clinical]] change
*Local [[therapy]] includes:
**[[Surgery]]
**Intra-lesional injection of [[vinblastine]], [[topical]] [[retinoid]], [[radiotherapy]], and [[cryotherapy]].
**[[Radiotherapy]]: The treatment option for the multifocal but relatively localized [[KS]]. <br />
|-
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold;" rowspan="6;" | Endemic African Kaposi's sarcoma <ref name="pmid213772672">{{cite journal| author=Uldrick TS, Whitby D| title=Update on KSHV epidemiology, Kaposi Sarcoma pathogenesis, and treatment of Kaposi Sarcoma. | journal=Cancer Lett | year= 2011 | volume= 305 | issue= 2 | pages= 150-62 | pmid=21377267 | doi=10.1016/j.canlet.2011.02.006 | pmc=3085592 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21377267  }}</ref>
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold;" rowspan="1;"|Common features
|-
| style="padding: 5px 5px; background: #F5F5F5;" |
* Usually seen in areas with high [[prevalence]] of [[HHV-8]] such as sub-Saharan Africa, called, Kaposi’s sarcoma-associated [[herpesvirus]] ([[KSHV]])
*Seropositivity in Sub-Saharan Africa is >50%
*If caused by an undiagnosed [[HIV]] infection, it can be treated by [[antiretroviral]] medications
*<nowiki/><nowiki/><nowiki/>If caused by [[infection]] other than [[HIV]], it can be treated by [[radiotherapy]] or [[chemotherapy]]
*The limitations of achieving an optimal and affordable [[therapeutic]] approach in sub-Saharan Africa is:
**Resource-limited settings and infrastructure issues such as lack of trained personnel to administer [[chemotherapy]] and lack of [[infusion]] centers, and the inability to monitor blood work, a high rate of co-morbid [[tuberculosis]]
*Oral agents such as [[etoposide]] may have the benefit of easing the administration
|-
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold;" rowspan="1;"|African [[cutaneous]]  Kaposi's sarcoma
|-
| style="padding: 5px 5px; background: #F5F5F5;" |
*[[Risk factors]] (other than [[HIV]])
** Chronic [[malaria]]
** Chronic [[parasitic infections]]
**[[Malnutrition]]
|-
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold;" rowspan="1;"|African [[Lymphadenopathy|lymphadenopathic]]  Kaposi's sarcoma
|-
| style="padding: 5px 5px; background: #F5F5F5;" |
* A very [[aggressive]] form
* Affects very young children, < 10 years of age
* Not related to [[HIV]]
*Affects the [[skin]] and [[lymph nodes]]
|-
| rowspan="1;" style="padding: 5px 5px; background: #DCDCDC; font-weight: bold;" |[[Iatrogenic]] ([[transplant]]-related) Kaposi's sarcoma ([[immunosuppression]]-associated Kaposi's sarcoma)<ref name="pmid4884743">{{cite journal| author=Siegel JH, Janis R, Alper JC, Schutte H, Robbins L, Blaufox MD| title=Disseminated visceral Kaposi's sarcoma. Appearance after human renal homograft operation. | journal=JAMA | year= 1969 | volume= 207 | issue= 8 | pages= 1493-6 | pmid=4884743 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=4884743  }}</ref><ref name="pmid728865">{{cite journal| author=Klepp O, Dahl O, Stenwig JT| title=Association of Kaposi's sarcoma and prior immunosuppressive therapy: a 5-year material of Kaposi's sarcoma in Norway. | journal=Cancer | year= 1978 | volume= 42 | issue= 6 | pages= 2626-30 | pmid=728865 | doi=10.1002/1097-0142(197812)42:6<2626::aid-cncr2820420618>3.0.co;2-7 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=728865  }}</ref>
| style="padding: 5px 5px; background: #F5F5F5;" |
* The association of [[KS]] with [[immunosuppression]] is noted in solid [[organ]] [[transplant]] [[patients]] and other [[patients]] on chronic [[immunosuppressive]] agents
*Reduction or removal of [[immunosuppression]] may not always lead to a resolution of [[KS]]
*[[Systemic therapy]] with  liposomal [[doxorubicin]] should be considered if [[immunosuppression]] removal didn't work or was not possible
 
<br />
 
*
|-
| rowspan="1;" style="padding: 5px 5px; background: #DCDCDC; font-weight: bold;" |(Epidemic) [[AIDS]]-associated Kaposi's sarcoma<ref name="pmid21751599">{{cite journal| author=Thomas S, Sindhu CB, Sreekumar S, Sasidharan PK| title=AIDS associated Kaposi's sarcoma. | journal=J Assoc Physicians India | year= 2011 | volume= 59 | issue=  | pages= 387-9 | pmid=21751599 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21751599  }}</ref><ref name="Friedman-KienSaltzman1990">{{cite journal|last1=Friedman-Kien|first1=Alvin E.|last2=Saltzman|first2=Brian R.|title=Clinical manifestations of classical, endemic African, and epidemic AIDS-associated Kaposi's sarcoma|journal=Journal of the American Academy of Dermatology|volume=22|issue=6|year=1990|pages=1237–1250|issn=01909622|doi=10.1016/0190-9622(90)70169-I}}</ref>
| style="padding: 5px 5px; background: #F5F5F5;" |
* The most common [[malignant]] [[neoplasm]] occurring in [[AIDS]] [[patients]]
*A highly varied [[neoplastic]] disease
*Characterized by multifocal [[mucocutaneous]] [[lesions]], often with [[lymphatic]] and [[visceral]] involvement
*The first [[epidemic]] occurred in [[homosexual]] men in 1981 in NewYork and California.
*95% of all [[AIDS]]_associated Kaposi's sarcoma ([[AIDS]]-KS) are in [[homosexual]] men
*The remaining 5% occurs in other population who are at risk of [[AIDS]]
*[[Etiology]] [[hypotheses]]:
**Endothelial-tumor [[growth factors]]
**[[Oncogenic]] [[expression]]
**[[Genetic]] predisposition
**Environmental cofactors
**Direct [[virus]]-like agent unidentified yet
*All available [[treatments]] help control the [[lesions]], none lengthens [[Survival rate|survival]]
*[[Treatments|Treatment]] includes:
**Localized [[radiation]] therapy
**[[Cryotherapy]]
**[[Electrocautery|Electrocauterization]]
**[[Surgical]] [[excision]]
**[[Systemic]] [[chemotherapeutic]] regimens
**[[Interferon]]
 
*
 
<br />
 
*


# Classic Kaposi sarcoma; as originally described was a relatively indolent disease affecting elderly men from the Mediterranean region, or of Eastern European descent.  Countries bordering the Mediterranean basin have higher rates of KSHV/HHV-8 infection than the remainder of Europe <ref>{{cite journal |last=Iscovich |first=J |year=1998 |month=Oct 22|title=Classic Kaposi's sarcoma in Jews living in Israel, 1961-1989: a population-based incidence study |journal=AIDS |volume=12 |issue=15 |pages=2067–72 |id=|accessdate= |quote= |doi=10.1097/00002030-199815000-00019 |pmid=9814876 |last2=Boffetta |first2=P |last3=Winkelmann |first3=R |last4=Brennan |first4=P |last5=Azizi |first5=E }}</ref><ref>{{cite journal |last=Fenig |first=E |year=1998 |month=October |title=Classic Kaposi sarcoma: experience at Rabin Medical Center in Israel |journal=Am J Clin Oncol |volume=21 |issue=5 |pages=498–500 |id= |url=http://www.amjclinicaloncology.com/pt/re/ajco/abstract.00000421-199810000-00016.htm;jsessionid=Gy0Jys29KWqzWg4RWhQN9vCyvP3tMPn24WG35BQbdLHGlhJc1y7S!-1804036389!-949856145!8091!-1 |accessdate= |quote= |doi=10.1097/00000421-199810000-00016 |pmid=9781608 |last2=Brenner |first2=B |last3=Rakowsky |first3=E |last4=Lapidoth |first4=M |last5=Katz |first5=A |last6=Sulkes |first6=A }}</ref>
|}
# Endemic KS, which has two types, African [[cutaneous]] Kaposi sarcoma and African [[lymphadenopathy|lymphadenopathic]] Kaposi sarcoma was described later in young African people, mainly from sub-Saharan Africa, as a more aggressive disease that [[infiltrate]]d the skin extensively, especially on the lower limbs. This, it should be noted, is not related to [[HIV]] infection.  KS is prevalent worldwide.<ref>{{cite journal |last=Cook-Mozaffari |first=P |year=1998 |month=December |title=The geographical distribution of Kaposi's sarcoma and of lymphomas in Africa before the AIDS epidemic |journal=Br J Cancer |volume=78 |issue=11 |pages=1521–8 |pmid=9836488 |accessdate= |quote= |last2=Newton |first2=R |last3=Beral |first3=V |last4=Burkitt |first4=DP |pmc=2063225 |doi=10.1038/bjc.1998.717 }}</ref><ref>{{cite journal |last=Olsen |first=SJ | year=1998 |month=October |title=Increasing Kaposi's sarcoma-associated herpesvirus seroprevalence with age in a highly Kaposi's sarcoma endemic region, Zambia in 1985 |journal=AIDS |volume=12 |issue=14 |pages=1921–5 |id= |format=PDF|accessdate= |quote= |doi=10.1097/00002030-199814000-00024 |pmid=9792393 |last2=Chang |first2=Y |last3=Moore |first3=PS |last4=Biggar |first4=RJ |last5=Melbye |first5=M }}</ref>
# [[Immunosuppression]]-associated Kaposi sarcoma had been described, but only rarely until the advent of [[Immunosuppressive drug#Drugs acting on immunophilins|calcineurin inhibitors]] (such as [[ciclosporin]]es, which are inhibitors of [[T-cell]] function) for [[Organ transplant|transplant]] patients in the 1980s, when its incidence grew rapidly.  The tumor arises either when an HHV 8-infected organ is transplanted into someone who has not been exposed to the virus or when the transplant recipient already harbors pre-existing HHV 8 infection.<ref>{{cite journal |last=Qunibi |first=W | year =1998 |month=Feb 27 |title=Serologic association of human herpesvirus eight with posttransplant Kaposi's sarcoma in Saudi Arabia |journal=Transplantation |volume=65 |issue=4 |pages=583–5 |id= |url=http://www.transplantjournal.com/pt/re/transplantation/abstract.00007890-199802270-00024.htm;jsessionid=Gy4Gq82dl1t9ppllm80G1PDjkbpmqFFkp2ypLSLnW2DthLg22DcM!220059229!-949856144!8091!-1 |accessdate= |quote= |doi=10.1097/00007890-199802270-00024 |pmid=9500639 |last2=Al-Furayh |first2=O |last3=Almeshari |first3=K |last4=Lin |first4=SF |last5=Sun |first5=R |last6=Heston |first6=L |last7=Ross |first7=D |last8=Rigsby |first8=M |last9=Miller |first9=G }}</ref><ref>{{cite journal |last= Luppi |first=Mario | year=2000 |month=Nov 9 |title=Bone marrow failure associated with human herpesvirus 8 infection after transplantation |journal=N Engl J Med |volume=343 |issue=19 |pages=1378–85 |id= |doi= 10.1056/NEJM200011093431905 |accessdate= |quote= |pmid=11070102 |last2= Barozzi |first2= P |last3= Schulz |first3= TF |last4= Setti |first4= G |last5= Staskus |first5= K |last6= Trovato |first6= R |last7= Narni |first7= F |last8= Donelli |first8= A |last9= Maiorana |first9= A }}</ref>
#AIDS-associated Kaposi sarcoma or Epidemic KS was described during the 1980s as an aggressive disease in [[AIDS]] patients (HIV also causes a defect in T-cell immunity). It is over 300 times more common in AIDS patients than in renal transplant recipients. In this case, HHV 8 is sexually transmitted among people also at risk for sexually transmitted HIV infection.<ref>{{cite journal |author=Beral V, Peterman TA, Berkelman RL, Jaffe HW |title=Kaposi's sarcoma among persons with AIDS: a sexually transmitted infection? |journal=Lancet |volume=335 |issue=8682 |pages=123–8 |year=1990 |month=January |pmid=1967430 |doi=10.1016/0140-6736(90)90001-L |url=http://linkinghub.elsevier.com/retrieve/pii/0140-6736(90)90001-L}}</ref>


==References==
==References==
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Latest revision as of 16:00, 4 November 2019


Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Haytham Allaham, M.D. [2] Huda A. Karman, M.D.

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Overview

Kaposi's sarcoma may be classified according to the clinical setting of the disease into five subtypes include Classic Kaposi's sarcoma, African cutaneous Kaposi's sarcoma, African lymphadenopathic Kaposi's sarcoma, Immunosuppression-associated Kaposi's sarcoma, and AIDS-associated Kaposi's sarcoma.

Classification

Types Characteristics
Classic (Mediterranean) Kaposi's sarcoma [4][5][6][7]
Endemic African Kaposi's sarcoma [8] Common features
  • Usually seen in areas with high prevalence of HHV-8 such as sub-Saharan Africa, called, Kaposi’s sarcoma-associated herpesvirus (KSHV)
  • Seropositivity in Sub-Saharan Africa is >50%
  • If caused by an undiagnosed HIV infection, it can be treated by antiretroviral medications
  • If caused by infection other than HIV, it can be treated by radiotherapy or chemotherapy
  • The limitations of achieving an optimal and affordable therapeutic approach in sub-Saharan Africa is:
    • Resource-limited settings and infrastructure issues such as lack of trained personnel to administer chemotherapy and lack of infusion centers, and the inability to monitor blood work, a high rate of co-morbid tuberculosis
  • Oral agents such as etoposide may have the benefit of easing the administration
African cutaneous Kaposi's sarcoma
African lymphadenopathic Kaposi's sarcoma
Iatrogenic (transplant-related) Kaposi's sarcoma (immunosuppression-associated Kaposi's sarcoma)[9][10]


(Epidemic) AIDS-associated Kaposi's sarcoma[11][12]


References

  1. ↑ Uldrick TS, Whitby D (June 2011). "Update on KSHV epidemiology, Kaposi Sarcoma pathogenesis, and treatment of Kaposi Sarcoma". Cancer Lett. 305 (2): 150–62. doi:10.1016/j.canlet.2011.02.006. PMID 21377267.
  2. ↑ Krigel RL, Laubenstein LJ, Muggia FM (June 1983). "Kaposi's sarcoma: a new staging classification". Cancer Treat Rep. 67 (6): 531–4. PMID 6861160.
  3. ↑ Grayson W, Pantanowitz L (July 2008). "Histological variants of cutaneous Kaposi sarcoma". Diagn Pathol. 3: 31. doi:10.1186/1746-1596-3-31. PMC 2526984. PMID 18655700.
  4. ↑ Vincenzi B, D'Onofrio L, Frezza AM, Grasso RF, Fausti V, Santini D; et al. (2015). "Classic Kaposi Sarcoma: to treat or not to treat?". BMC Res Notes. 8: 138. doi:10.1186/s13104-015-1076-1. PMC 4395989. PMID 25889316.
  5. ↑ Stratigos, John; Potouridou, Irene; Katoulis, Alexander; Hatziolou, Eftichia; Christofidou, Eleftheria; Stratigos, Alexander; Hatzakis, Angelos; Stavrianeas, Nicholas (1997). "Classic Kaposi's sarcoma in Greece: a clinico-epidemiological profile". International Journal of Dermatology. 36 (10): 735–740. doi:10.1046/j.1365-4362.1997.00284.x. ISSN 0011-9059.
  6. ↑ Landau HJ, Poiesz BJ, Dube S, Bogart JA, Weiner LB, Souid AK (2001). "Classic Kaposi's sarcoma associated with human herpesvirus 8 infection in a 13-year-old male: a case report". Clin Cancer Res. 7 (8): 2263–8. PMID 11489800.
  7. ↑ Cetin, Bulent; Aktas, Bilge; Bal, Oznur; Algin, Efnan; Akman, Tulay; Koral, Lokman; Kaplan, Mehmet Ali; Demirci, Umut; Uncu, Dogan; Ozet, Ahmet (2018). "Classic Kaposi's sarcoma: A review of 156 cases". Dermatologica Sinica. 36 (4): 185–189. doi:10.1016/j.dsi.2018.06.005. ISSN 1027-8117.
  8. ↑ Uldrick TS, Whitby D (2011). "Update on KSHV epidemiology, Kaposi Sarcoma pathogenesis, and treatment of Kaposi Sarcoma". Cancer Lett. 305 (2): 150–62. doi:10.1016/j.canlet.2011.02.006. PMC 3085592. PMID 21377267.
  9. ↑ Siegel JH, Janis R, Alper JC, Schutte H, Robbins L, Blaufox MD (1969). "Disseminated visceral Kaposi's sarcoma. Appearance after human renal homograft operation". JAMA. 207 (8): 1493–6. PMID 4884743.
  10. ↑ Klepp O, Dahl O, Stenwig JT (1978). "Association of Kaposi's sarcoma and prior immunosuppressive therapy: a 5-year material of Kaposi's sarcoma in Norway". Cancer. 42 (6): 2626–30. doi:10.1002/1097-0142(197812)42:6<2626::aid-cncr2820420618>3.0.co;2-7. PMID 728865.
  11. ↑ Thomas S, Sindhu CB, Sreekumar S, Sasidharan PK (2011). "AIDS associated Kaposi's sarcoma". J Assoc Physicians India. 59: 387–9. PMID 21751599.
  12. ↑ Friedman-Kien, Alvin E.; Saltzman, Brian R. (1990). "Clinical manifestations of classical, endemic African, and epidemic AIDS-associated Kaposi's sarcoma". Journal of the American Academy of Dermatology. 22 (6): 1237–1250. doi:10.1016/0190-9622(90)70169-I. ISSN 0190-9622.


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