Pyogenic granuloma like kaposi sarcoma

Since the advancements in treatment of Human Immunodeficiency Virus (HIV), we have seen a decline in the number of presentations of Kaposi’s Sarcoma (KS).1 The pathogen responsible for KS, human herpes virus 8 (HHV-8) also known as Kaposi’s Sarcoma-associated Herpes Virus (KSHV) is thought to be transmitted sexually, through the faecal oral route, ejaculate or saliva.2 We describe a case of a 70-year-old male who presented with a tender lesion on the lateral aspect of the dorsum right foot with an onset six months prior. Symptoms included frequent bleeding, tenderness and most recently a satellite lesion adjacent to the primary. Clinically, the lesions had features consistent with a pyogenic granuloma and a curette and cautery was performed. Histology demonstrated a Kaposi Sarcoma with proliferating spindle cells and slit like vascular spaces staining positive for D2-40 (Podoplanin) and HHV-8. On further history, the patient admitted to being HIV positive for thirty years without current or previous antiretroviral treatment. His most recent viral load three months prior was undetectable. On further clinical examination one month later, numerous small patch KS were evident elsewhere on the lower leg. He was subsequently referred for treatment of his HIV and recommended antiretroviral therapy. HIV related KS is one of the four clinically recognised subsets of KS. As clinicians, we are seeing fewer presentations of KS compared with the HIV epidemic of the 1980s and 1990s and as such can be challenging to diagnose.

Dr. Sharon Gabizon

Northern Dermatology, Chermside, QLD

Dr. Sharon Gabizon is an Honorary Dermatology Registrar in South-East Queensland at Northern Dermatology, Chermside; Gabba Dermatology, Woolloongabba; Princess Alexandra Hospital, Woolloongabba. Additionally, he is a Research Assistant for the Dermatology Research Centre, University of Queensland, Diamantina Institute in the Cross-sectional Microbiome Study for Transplant Recipients and also an Honorary Advanced Research Fellow for the Critical Care Research Group, University of Queensland, Prince Charles Hospital investigating the effects of brain death on sheep skin neurons in the superficial and deep dermis. He is a Sub Investigator in over 30 clinical trials including those assessing the efficacy of the latest biologics targeting psoriasis and atopic dermatitis at Veracity Clinical Research, Woolloongabba. Sharon holds a MBBS from Griffith University, QLD and a BBMedSc from Monash University, VIC, majoring in anatomy.