Bowenoid changes in Kaposi's sarcoma

Penile intraepithelial neoplasia overlying Kaposi's sarcoma lesions: role of viral synergy?

Several viral agents have been detected in the lesional tissue of Kaposi's sarcoma (KS). Their precise oncogenic role remains to be determined. A 32-year-old heterosexual man with acquired immunodeficiency syndrome (AIDS) who had penile lesions of KS with overlying epithelial changes characteristic of intraepithelial neoplasia associated with concurrent infection by human papillomavirus (HPV) and human herpesvirus 8 (HHV-8) is reported. The absence of viral DNA from uninvolved skin suggests that this coinfection is more than coincidental and may involve synergy between these viruses, as has already been suggested for HPV and herpes simplex 2 virus.

Skin cancers associated with acquired immunodeficiency syndrome

OBJECTIVE

To describe the types of skin cancer associated with the acquired immunodeficiency syndrome (AIDS).

DESIGN

A literature review of AIDS-related mucocutaneous neoplasms, including basal cell carcinoma, squamous cell carcinoma, bowenoid papulosis and Bowen's disease, squamous cell carcinoma, cloacogenic carcinoma, and malignant melanoma, is presented, and the incidence, etiopathogenesis, clinicopathologic features, treatment, and prognosis are discussed.

RESULTS

The association between cutaneous neoplasms and AIDS is well known. Neoplasms seem to grow more rapidly and be more invasive in patients with AIDS than in other groups of patients. Several oncogenic factors--for example, sunlight exposure or human papillomavirus infection--have been associated with the development of skin cancer in these patients. The morbidity and mortality rates of skin cancer are higher in patients infected with the human immunodeficiency virus (HIV) than in the general population. Early and complete excision of the neoplasm is especially important.

CONCLUSION

A link exists between AIDS and the development of skin cancer. HIV-infected patients should be followed up vigilantly for early diagnosis of skin cancer. Because these patients are less able to suppress common cutaneous malignant disease due to their immunocompromised status, biopsy specimens should be obtained from all suspicious lesions, and histopathologic assessment should be done.

EBV-associated Kaposi's sarcoma in a pediatric renal transplant recipient

A 7-year-old boy had undergone kidney transplantation for chronic renal failure secondary to bilateral renal hypoplasia. He developed acute and chronic rejection and received immunosuppressive therapy. A year later he died with EBV-associated hemophagocytic syndrome. The main pathologic findings disclosed visceral (lung and stomach) and abdominal lymph node involvement of Kaposi's sarcoma and EBV-positive immunoblasts in several organs. In the lungs and lymph nodes these had the features of polymorphous lymphoimmunoblastic lesions. Because of the peculiar distribution of Kaposi's sarcoma lesions a pathogenetic hypothesis is proposed based on the site of entry of the virus. This case contributes to expanding the relationship between Kaposi's sarcoma and kidney transplantation in the pediatric population.