Steroid induced exacerbation in kaposi sarcoma, a clinical paradox: a case report

Abstract

Introduction: Kaposi sarcoma is uncommonly encountered in clinical practice. It is described as vascular malignancy associated with HHV-8 infection. It most commonly affects skin, but can also affect mucosal surfaces, lymphatics and visceral organs. In recent times, with availability of HAART and newer chemotherapy agents, prognosis has improved. One of the complications associated with KS is exacerbation secondary to immune reconstitution with initiation of ART and Steroid.

Case presentation: Hereby We example case of 17-year-old male presented as Kaposi sarcoma with steroid induced exacerbation. Through this case, we enlighten the epidemiology, clinical features and management of such patients which might help clinicians in further management.

Discussion: One of the complications associated with Kaposi sarcoma is exacerbation associated with initiation of antiretroviral therapy (ART) which might lead to Immune reconstitution inflammatory syndrome (IRIS) and steroids induced flare, and thus steroids are contraindicated even as management of IRIS.

Conclusion: Use of corticosteroid may cause life threatening exacerbation and prompt initiation of cytotoxic agent may prove to be beneficial.