Kaposi's sarcoma classification: Difference between revisions

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{{CMG}}
{{Kaposi's sarcoma}}


==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.
# 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==
{{Reflist|2}}
[[Category:Disease]]
[[Category:HIV/AIDS]]
[[Category:Types of cancer]]
[[Category:Dermatology]]
[[Category:Pulmonology]]
[[Category:Gastroenterology]]
[[Category:Infectious disease]]
[[Category:Needs overview]]
{{WH}}
{{WS}}

Revision as of 22:48, 18 January 2016