Kaposi's sarcoma/AIDS cofactors

Skin lesions in HIV-positive and HIV-negative patients in south India

BACKGROUND

Various dermatologic conditions have been reported to occur with increased frequency in human immunodeficiency virus (HIV)-positive individuals, but there are only a few studies comparing the prevalences of skin diseases in HIV-positive patients with those in matched HIV-negative controls.

METHODS

Skin lesions in 129 HIV-positive patients and 258 HIV-negative controls were studied prospectively over an 18-month period from October 1991 to March 1993.

RESULTS

Oral candida, tinea cruris, and ichthyosis were significantly more common in HIV-positive patients compared to controls. Several other dermatologic conditions were found only in the HIV-positive group.

CONCLUSIONS

The pattern of skin lesions in Indian patients with HIV infection may be different from that in the West.

Kaposi's sarcoma: advances and perspectives

Kaposi's sarcoma (KS) is an unusual neoplasm that has proved to be an enigma in many ways since its original description by Kaposi in 1872. Its epidemiology has stimulated tremendous interest, amplified markedly in 1981 when it became known as an original defining part of the complex of immune disorders now known as AIDS. The cell of origin, etiology, and therapy for both AIDS-associated and AIDS-unassociated KS continue as matters of intense investigation. In fact, whether it is a reactive hyperplasia or a true malignancy is still a matter of debate, as is the concept of multicentricity versus metastases. Epidemiologic studies suggest that a separate agent apart from HIV-1 may cause KS. A newly postulated KS-associated herpes virus may be linked. The role of the HIV-1 tat gene product, basic fibroblast growth factor, scatter factor, oncostatin M, and other factors that regulate the growth of KS cells are discussed, as well as therapeutic options.

Apolipoprotein E (ApoE), a novel heparin-binding protein inhibits the development of Kaposi's sarcoma-like lesions in BALB/c nu/nu mice

Recombinant apolipoprotein E-3 (ApoE-3), expressed in Escherichia coli, was purified and used in an in vitro and an in vivo model system for acquired immunodeficiency syndrome-associated Kaposi's sarcoma (AIDS-KS). This protein blocked cell proliferation and chemotaxis of AIDS-KS cells in response to activated lymphocyte conditioned medium (AL-CM) and oncostatin M (OSM). ApoE-3 also inhibited the formation of neoangiogenic lesions induced in BALB/c nu/nu mice by AIDS-KS cells. These findings represent a novel and potentially less toxic therapeutic approach for the treatment of AIDS-KS.

HIV-related tumors of the oral cavity

In HIV-infected patients with AIDS the most frequent malignancies are Kaposi's sarcoma and non-Hodgkin's lymphoma. In these patients, the natural history of these tumors is quite different from those of HIV-negative subjects. These tumors may present atypical clinical aspects, may be very aggressive, and the coexistence of immunosuppression and opportunistic infections may render their treatment more difficult. The aim of this article is to provide updated information on the epidemiology, pathogenesis, natural history, and management of tumors that develop in the oral cavity of patients with AIDS.

Bowenoid changes in Kaposi's sarcoma

BACKGROUND

Previous reports have documented the coexistence of multiple infectious organisms or Kaposi's sarcoma within the same biopsy specimens of mucocutaneous lesions in human immunodeficiency virus- (HIV) infected patients.

OBJECTIVE

A 31-year-old black man with the acquired immunodeficiency syndrome (AIDS) who had Bowenoid changes and Kaposi's sarcoma within the same cutaneous lesion is described.

METHODS

Microbiologic cultures, microscopic examination, and polymerase chain reaction were performed on a lesional skin biopsy specimen to evaluate for infectious organisms, histopathology, and the presence of human papillomavirus (HPV) deoxyribonucleic acid (DNA), respectively.

RESULTS

Bacteria, fungi, and mycobacteria were not detected with special stains and cultures. The histologic findings were consistent with Bowen's disease in the epidermis and patch stage Kaposi's sarcoma in the dermis. There was no polymerase chain reaction product generated from the HPV-specific primers in two individual polymerase chain reaction assays.

CONCLUSION

The possibility that coexisting infectious or neoplastic disorders, or both, may be present within a single mucocutaneous lesion should always be considered when evaluating a lesion from an HIV seropositive individual.