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Disseminated manifestation of Kaposi’s Sarcoma in newly diagnosed AIDS in an african female

机译:卡波济肉瘤在非洲女性新诊断出的艾滋病中的传播表现

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Background: Kaposi’s sarcomas are the most frequent malignancies in patients with AIDS and there is increasing evidence of an association with human Herpesvirus 8 (HHV-8). A reconstitution of the immune response due to different regimens of highly active antiretroviral therapy (HAART) is the most important step in treatment of Kaposi’s sarcomas. Local treatment options include the topic application of alitretionin (9-cis-retinoic acid) as a gel, cryotherapy with liquid nitrogen and intralesional vinblastine, as well as local laser or low-dose X-ray treatment. A systemic chemotherapy can be taken under consideration in selected cases with clinical significant visceral lesions or aggressive sarcomatous behavior with anthracyclines, taxanes, as well as an immunomodulatory treatment with alpha Interferon.Case Report: The case of an african emigrant is described. Hospitalized due to recurrent fever and diarrhea, the diagnosis of AIDS was quickly established. The physical examination revealed multiple nodular, painless skin lesions suspicious of Kaposi’s sarcoma. The diagnosis was confirmed histologically, later on also in bronchial and duodenal biopsies due to the atypical subepithelial vessels with slit-like appearance and prominent endothelia.Conclusions: Cutaneous lesions in patients with dark skin colour may be unfamiliar to European physicians. In patients with HIV-infection, nodular skin lesions should lead suspicion to Kaposi’s sarcoma. If this diagnosis is established, it should be clarified, if other locations (e.g.: intestine, respiratory tract) are involved, too.
机译:背景:卡波西肉瘤是艾滋病患者中最常见的恶性肿瘤,越来越多的证据表明它与人类疱疹病毒8(HHV-8)有关。治疗卡波西氏肉瘤最重要的步骤是重组因高抗逆转录病毒疗法(HAART)的方案而引起的免疫反应。局部治疗的选择包括主题应用alteretionin(9-顺-视黄酸)作为凝胶剂,液氮和病灶内长春碱的冷冻疗法以及局部激光或小剂量X射线治疗。在某些临床上明显的内脏病变或蒽环类,紫杉烷类侵袭性肉瘤行为以及α-干扰素的免疫调节治疗的病例中,可以考虑进行全身化疗。病例报告:描述了非洲移民病例。由于反复发烧和腹泻住院,迅速诊断出艾滋病。体格检查发现可疑卡波西肉瘤的多个结节性,无痛性皮肤病变。该诊断在组织学上得到确认,后来在支气管和十二指肠活检中也由于非典型的上皮下血管具有裂痕状外观和突出的内皮而被确诊。在感染了HIV的患者中,结节性皮肤损害应引起对卡波济肉瘤的怀疑。如果确定了这种诊断,则还应弄清是否也涉及其他位置(例如:肠道,呼吸道)。

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