Tuesday, May 19, 2009

Kaposi's sarcoma-associated herpesvirus transmission and primary infection

Kaposi's sarcoma-associated herpesvirus transmission and primary infection

Curr Opin HIV AIDS. 2009 Jan

Bagni R, Whitby D.
Viral Oncology Section, AIDS and Cancer Virus Program, SAIC-Frederick, NCI-Frederick, Frederick, Maryland 21702, USA.

PURPOSE OF REVIEW: Kaposi's sarcoma-associated herpesvirus (KSHV), also known as human herpesvirus 8, is the causal agent of Kaposi's sarcoma, one of the commonest cancers in HIV-infected individuals. Transmission and risk factors for infection by KSHV are not fully understood. The purpose of this review is to highlight recent advances in our understanding of KSHV transmission in various settings.

RECENT FINDINGS: KSHV and HIV are both common in southern Africa where KSHV infection occurs during childhood via saliva. HIV infection is a major risk factor for KSHV infection. In developed countries, KSHV transmission among men who have sex with men is related to sexual risk factors such as number of sexual partners and to sexual practices involving saliva. KSHV can be transmitted by transfusion of infected blood, but storage of blood products diminishes the risk.

SUMMARY: Recent reports have provided much additional insight into KSHV transmission in different populations, but have also provided a number of important questions for the research and public health communities. Most critically, the role of HIV in increasing risk for KSHV infection and the possible effects on KSHV prevalence, and consequently the incidence of Kaposi's sarcoma warrants urgent further study.

Lippincott, Williams & Wilkins

Dermoscopy of Kaposi's sarcoma: Areas exhibiting the multicoloured 'rainbow pattern'

Dermoscopy of Kaposi's sarcoma: Areas exhibiting the multicoloured 'rainbow pattern'
J Eur Acad Dermatol Venereol. 2009 Apr 10

Hu SC, Ke CL, Lee CH, Wu CS, Chen GS, Cheng ST.
Department of Dermatology.

Abstract Background Kaposi's sarcoma is a vascular tumour characterized by a proliferation of spindle cells and endothelial cells to form closely arranged slit-like vascular spaces. Currently, the definitive diagnosis of Kaposi's sarcoma relies on histology. The dermoscopic features of Kaposi's sarcoma are not clearly defined in the scientific literature. Objectives We seek to evaluate the dermoscopic features of Kaposi's sarcoma and compare them with other vascular tumours. Methods One hundred forty-one lesions from seven patients with histologically proven Kaposi's sarcoma were evaluated using polarized light dermoscopy for the presence of various dermoscopic features. Twenty patients with other vascular tumours were also examined. Results Dermoscopic examination revealed bluish-reddish coloration (84% of lesions), multicoloured areas showing various colours of the rainbow spectrum (36%), scaly surface (29%), and small brown globules (15%). The 'rainbow pattern' was found in six out of seven patients with Kaposi's sarcoma and was not observed in other vascular tumours. In addition, there was an absence of dermoscopic features specific for other vascular and non-vascular skin tumours, such as well-defined lacunae or structured vascular pattern, in most of the Kaposi's sarcoma lesions. Conclusions The most frequent dermoscopic patterns in Kaposi's sarcoma were found to be bluish-reddish coloration, the 'rainbow pattern', and scaly surface. The rainbow pattern is a dermoscopic feature which has not been previously described. We propose that dermoscopy, as an adjunct to clinical examination, may enhance accuracy in the preoperative diagnosis of Kaposi's sarcoma.

Conflicts of interest None declared

Wiley InterScience