AIDS-associated Kaposi sarcoma - External and Internal Eye
The outbreak of KS among young, previously healthy men who have sex with men (MSM) heralded the recognition of AIDS in 1981. AIDS-associated KS is the most common neoplasm in HIV-seropositive patients and is an AIDS-defining illness. This form of KS is primarily seen in the MSM population, but it can be seen in female partners of men with the disease in addition to HIV-infected women. About 40% of men with AIDS develop KS. Lesions may worsen during immune reconstitution inflammatory syndrome and may also appear in patients with HIV who have received long-term antiretroviral therapy (ART).
Ophthalmic involvement, most often of the conjunctiva and eyelid, occurs in around one-fifth of patients with AIDS-related KS. These lesions may be rapidly growing.
Generally, lesions around the eye are slow growing, but KS can cause pain, photophobia, tearing, trichiasis, lagophthalmos, and visual loss.
The introduction of ART dramatically decreased the incidence, morbidity, and mortality of AIDS-associated KS.
C46.0 – Kaposi's sarcoma of skin
420524008 – Kaposi's sarcoma associated with AIDS
Differential Diagnosis & Pitfalls
- Bacillary angiomatosis
- Lobular capillary hemangioma (pyogenic granuloma)
- Lichen simplex chronicus
- Metastatic carcinoma or melanoma
- Pigmented basal cell carcinoma
- Blue rubber bleb nevus syndrome
- Tufted angioma
- Cavernous hemangioma
- Arteriovenous malformation
- Leukemia cutis
- Early KS may resemble a large junctional nevus, a port-wine stain, or an ecchymosis.
- Angioinvasive fungal disease such as aspergillosis