HHV8 (Kaposi Sarcoma-Associated Herpesvirus [KSHV])

Figure 4.5 A: Pityriasis rosea, face (Courtesy of Dr. Paul Getz) B: Kaposi’s sarcoma Courtesy of National Cancer Institute C: Verruca vulgaris

(Figure 4.5B)

• Etiologic agent of all types of Kaposi’s sarcoma (KS)
• Four types of KS:
  • Classic: indolent, purple-red plaques on lower extremities in elderly men from Mediterranean descent, slow progression, rare involvement of GI tract and oral mucosa
  • AIDS-related: widely distributed purpuric macules, patches and plaques on skin, oral and genital mucosa, GI tract, and lung
  • Immunosuppression-associated: similar to AIDS-related KS with aggressive nature and dissemination
  • African endemic: aggressive, young patients in equatorial Africa, unrelated to HIV, subtypes include nodular, lymphadenopathic, florid, and infiltrative
• Other conditions associated with HHV8: Castleman’s disease (nonmalignant lymphoproliferative disorder) and primary effusion lymphoma
• Histology: spindle cells forming slit-like vascular channels with surrounding hemosiderin, promontory sign
• Treatment: topical retinoid, surgery, radiotherapy, cryotherapy, systemic chemotherapy for extensive disease, HAART if AIDS-related