Corticosteroid therapy has revolutionized the treatment of many diseases in medicine. The most concerned diseases are chronic inflammatory diseases. Its use may be either short-term or long-term, thus generating several side effects, some of which are conventional and known, but others are rare, such as Kaposi’s sarcoma. We report here a particular clinical observation. Observation: This is a patient of 37 years, who consults in Internal Medicine for the treatment of mucocutaneous lesions, papular nodular, hyper pigmented, budding and disseminated appeared after six months of corticosteroid therapy. This treatment was introduced for the treatment of acoustic neurinoma. The patient is not diabetic or alcoholic and has a negative HIV status. The diagnosis of Kaposi’s sarcoma was made by histology of biopsied skin lesions which concluded for a regular proliferation without atypia spindle cell or mitosis. The lesions persisted over a month despite discontinuation of corticosteroid therapy. Treatment with Bleomycin was necessary. The outcome was favorable under treatment with progressive and complete disappearance of lesions after 15 treatments. Conclusion: The classical side effects of long-term corticosteroid are known, but Kaposi sarcoma complicating long-term corticosteroid is rare in the literature. It is vital that any long-term corticosteroid should be the subject of careful and regular monitoring.
References
[1]
Chosidow, O. and Lebrun-Vignes, B. (2007) Corticothérapie par voie générale. Annales de Dermatologie et de Vénéréologie, 134, 942-948. http://dx.doi.org/10.1016/S0151-9638(07)78255-8
[2]
Farde, L., Blanchon, T., Perdoncini-Roux, A., Kettaneh, A., Tiev, K., Turbelin, C., Dorleans, Y., Chalet, J. and Hanslik, T. (2009) Perception par les médecins internistes de la fréquence et de la gêne induite par les effets indésirables d’une corticothérapie systémique prolongée. La Revue de Médecine Interne, 30, 113-118.
http://dx.doi.org/10.1016/j.revmed.2008.08.004
[3]
Kaposi, M. (1872) Idiopathic Multiple Pigmented Sarcoma of the Skin. Archiv für Dermatologie und Syphilis, 4, 265- 273. http://dx.doi.org/10.1007/BF01830024
[4]
Chang, Y., Cesarman, E., Pessin, M.S., Lee, F., Culpepper, J., Knowles, D.M. and Moore, P.S. (1994) Identification of Herpes Virus + Like DNA Sequences in AIDS Associated Kaposi’s Sarcoma. Science, 266, 1865-1869.
http://dx.doi.org/10.1126/science.7997879
[5]
Mohiuddin Wani, G.H., Ahmad, S.M., Qayoom, S.M., Khursheed, B. and Khan, A.R. (2012) Corticosteroid Induced, HHV-8 Positive Kaposi’s Sarcoma in a Non-HIV Elderly Patient. JIMA, 44, 2-4.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3708632/
http://dx.doi.org/10.5915/44-1-9317
[6]
Morand, J.J., Lightburn, E.F., Simon, F. and Patte, J.H. (2007) Actualités de la Maladie de Kaposi. Médecine Tropicale, 67, 123-130.
[7]
Chakib, A., Hliwa, W., Marih, L. and Himmich, H. (2003) Maladie de Kaposi au cours de l’infection par le VIH au Maroc. (A propos de 50 cas). Bulletin de la Société de Pathologie Exotique, 96, 86-89.
[8]
Lamchahab, F.E., Tadlaoui, I., Beqqal, K., Bouattar, T., Ouzeddoun, N., Bayahia, R., Aitourhroui, M., Senouci, K., Hassam, B. and Ismaili, N. (2011) La Maladie de Kaposi iatrogène au Maroc en dehors du contexte de la transplantation. Annales de Dermatologie et de Vénéréologie, 138, 729-735.
http://dx.doi.org/10.1016/j.annder.2011.06.007
[9]
Bruet, A., Mahe, A., Sei, J.F., Mathe, C., Felsenheld, C., Lechevalier, L. and Fendler, J.P. (1990) Kaposi’s Sarcoma Complicating Long-Term Corticotherapy for Severe Asthma. La Revue de Médecine Interne, 11, 322-324.
http://dx.doi.org/10.1016/S0248-8663(05)80867-7
[10]
El Bouchti, I., Akhdari, N., Amal, S. and El Hassani, S. (2009) Association d’une polyarthrite rhumatoide et d’une maladie de Kaposi: A propos d’un cas. Résumé Sélectionné (Me.56) au congrès de la Société Française de Rhumatologie. http://www.rhumatologie.asso.fr/data/ModuleProgramme/PageSite/2009-1/Resume/5037.asp
[11]
Casoli, P. and Tumiati, B. (1992) Rheumatoid Arthritis, Corticosteroid Therapy and Kaposi’s Sarcoma: A Coincidence? A Case and Review of Literature. Clinical Rheumatology, 11, 432-435. http://dx.doi.org/10.1007/BF02207213
[12]
Schottstaedt, M.W., Hurd E.R. and Stone, M.J. (1987) Kaposi’s Sarcoma in Rheumatoid Arthritis. The American Journal of Medicine, 82, 1021-1026. http://dx.doi.org/10.1016/0002-9343(87)90168-9
[13]
Leung, F., Fam, A.G. and Osoba, D. (1981) Kaposi’s Sarcoma Complicating Corticosteroid Therapy for Temporal Arteritis. The American Journal of Medicine, 71, 320-322. http://dx.doi.org/10.1016/0002-9343(81)90135-2
[14]
Meynadier, J., Guilhou, J.J., Peyron, J.L. and Guillot, B. (1981) Maladie de Kaposi chez un psoriasique soumis à une corticothérapie locale massive et prolongée. Clinique de Dermatologie et Syphiligraphie, Hôpital Saint-Charles, Montpellier, France. Dermatologica, 162, 417-423. http://dx.doi.org/10.1159/000250310
[15]
Laor, Y. and Schwartz, R.A. (1979) Epidemiologic Aspects of American’s Kaposi’s Sarcoma. Journal of Surgical Oncology, 12, 299-303. http://dx.doi.org/10.1002/jso.2930120403
[16]
Iscovich, J., Boffetta, P., Franceschi, S., Azizi, E. and Sarid, R. (2000) Classic Kaposi Sarcoma: Epidemiology and Risk Factoring. Cancer, 88, 500-517.
http://dx.doi.org/10.1002/(SICI)1097-0142(20000201)88:3<500::AID-CNCR3>3.0.CO;2-9
[17]
Schwartz, R.A. (1996) Kaposi’s Sarcoma: Advances and Perspectives. J Am Acad Dermatol, 34, 804-814.
http://dx.doi.org/10.1016/S0190-9622(96)90018-3
[18]
Zaraa, I., Labbène, I., El Guellali, N., Alaya, N.B., Mokni, M. and Osman, B.A. (2012) La maladie de Kaposi: Caractéristiques épidémio-cliniques, anatomopathologiques et thérapeutiques à propos de 75 cas. La Tunisie Médicale, 90, 116-121.
[19]
Rejeb, B.A., Ebdelli, N., Bouali, R.M., Goucha, A., Bougrine, F., Khediri, F. and Delsol, G. (2001) Sarcome de Kaposi digestif primitif avec lymphocytopénie CD4 idiopathique, VIH négatif, HHV8 positif. Gastroentérologie Clinique et Biologique, 25, 707-710.
[20]
Benjamin, P., Brownlee, N., Jain, A., Alwood, K., Dorman, S. and Agwu, A. (2006) Prolonged Diarrhea, Protein Losing Enteropathy, and Intestinal Perforation: An Illustrative Case of Kaposi Sarcoma HIV-Associated. The Internet Journal of Gastroenterology, 5, 1-6. http://ispub.com/IJGE/5/2/6133
[21]
Lin, O., Scholes, J.V. and Lustbader, I.J. (1994) Chylous Ascites Resulting from Kaposi’s Sarcoma in an AIDS Patient. The American Journal of Gastroenterology, 89, 2252-2253. http://www.ncbi.nlm.nih.gov/pubmed/7977258
[22]
Friedman, S.L., Wright, T.L. and Altman, D.F. (1985) Gastrointestinal Kaposi’s Sarcoma in the Patients with Acquired Immunodeficiency Syndrome. Endoscopic and Autopsy Findings. Gastroenterology, 89, 102-108.
http://www.ncbi.nlm.nih.gov/pubmed/4007399
