Monday, 2 June 2014

Kaposi sarcoma misdiagnosed as actinic lichen planus‏ in an HIV positive patient



The condition has been misdiagnosed by two dermatologists as actinic lichen planus for 5 months. 

Related article





Kaposi sarcoma (KS) is the commonest tumour in patients infected with HIV. It is an AIDS-defining illness and is caused by a γ herpesvirus, the Kaposi sarcoma herpesvirus (KSHV), also called Human Herpesvirus-8 (HHV-8).




It is recommended that KS should be confirmed histopathologically (healing of the biopsy site). 





Histopathological clues to Kaposi's sarcoma:

• Abnormal tissue spaces in the dermis
Promontory sign (small vessel protruding into an abnormal space)
Haemosiderin and plasma cells
Stuffing of all dilated neoplastic vessels with red blood corpuscles in the absence of plasma
• Established lesions have the usually documented features.
This page was last updated in November 2014

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Main Works of Reference List (The first eight are my top favourites)

  • British National Formulary
  • British National Formulary for Children
  • Guidelines (BAD - BASHH - BHIVA - Uroweb)
  • Oxford Handbook of Genitourinary Medicine, HIV, and Sexual Health
  • Oxford Handbook of Medical Dermatology
  • Rook's Textbook of Dermatology
  • Simple Skin Surgery
  • Weedon's Skin Pathology
  • A Concise Atlas of Dermatopathology (P Mckee)
  • Ackerman's Resolving Quandaries in Dermatology, Pathology and Dermatopathology
  • Andrews' Diseases of the Skin
  • Andrology (Nieschlag E FRCP, Behre M and Nieschlag S)
  • Bailey and Love's Short Practice of Surgery
  • Davidson's Essentials of Medicine
  • Davidson's Principles and Practice of Medicine
  • Fitzpatrick's Colour Atlas and Synopsis of Clinical Dermatology (Klaus Wolff FRCP and Richard Allen Johnson)
  • Fitzpatrick’s Dermatology in General Medicine
  • Ganong's Review of Medical Physiology
  • Gray's Anatomy
  • Hamilton Bailey's Demonstrations of Physical Signs in Clinical Surgery
  • Hutchison's Clinical Methods
  • Lever's Histopathology of the Skin
  • Lever's Histopathology of the Skin (Atlas and Synopsis)
  • Macleod's Clinical Examination
  • Martindale: The Complete Drug Reference
  • Oxford Handbook of Clinical Examination and Practical Skills
  • Oxford Textbook of Medicine
  • Practical Dermatopathology (R Rapini)
  • Sexually Transmitted Diseases (Holmes K et al)
  • Statistics in Clinical Practice (D Coggon FRCP)
  • Stockley's Drug Interactions
  • Treatment of Skin Disease: Comprehensive Therapeutic Strategies
  • Yen & Jaffe's Reproductive Endocrinology