Pedal presentation of Kaposi's sarcoma in a non-HIV Hispanic female: a case report and literature review

Rare Presentation of Kaposi's Sarcoma in an HIV-Negative Patient

Kaposi's sarcoma (KS) in the United States is prevalent in Eastern European or Mediterranean males. KS in HIV-negative patients is becoming increasingly prevalent and should not be limited to the 4 subtypes: classic, endemic, iatrogenic immunosuppression, and epidemic. We present a rare pedal presentation of KS in an immunocompetent, HIV-negative man who has sex with men (MSM) and was followed for 12 months. The prevalence of KS in HIV-negative MSM is slowly rising and fits into the rare, fifth subtype.

A case of mistaken identity: classic Kaposi sarcoma misdiagnosed as a diabetic foot ulcer in an atypical patient

Background

The presentation of Kaposi sarcoma is divided into four known clinical subtypes. In this case report we describe classic Kaposi sarcoma in an African-American heterosexual, diabetic, seronegative human immunodeficiency virus male. Classic Kaposi sarcoma is rare in this patient demographic and can be easily misdiagnosed.

Case presentation

The patient presented with a lesion between the fourth and fifth digits of his right foot which was initially diagnosed as a diabetic foot ulcer. Despite local wound care, the lesion did not resolve. A shave biopsy was performed and histopathology findings were consistent with classic Kaposi sarcoma.

Conclusions

The patient tolerated local radiotherapy well and had complete resolution of his pedal lesion. There have been emerging associations between diabetes and Kaposi sarcoma. As such, clinicians should have a low threshold when considering the biopsy of suspicious pedal lesions in patients with diabetes. The utilization of appropriate biopsy technique may lead to the diagnosis of classic KS tumors in populations outside of the current four widely accepted clinical subtypes.