[Iatrogenic Kaposi's disease in Morocco in a non-transplant context].

Abstract

BACKGROUND:

Kaposi's disease (KD) is a multifocal disease affecting the skin and viscera. KD can occur in an endemic setting: it may be associated with human immunodeficiency virus (HIV) or it may occur as a complication of immunosuppression, particularly of iatrogenic origin in transplant patients. The purpose of this study is to describe the epidemiological, clinical and therapeutic profile and the course of iatrogenic KD in Morocco in a setting not involving organ transplantation.

PATIENTS AND METHODS:

A retrospective study conducted at the dermatology department of the Ibn Sina hospital centre in Rabat, Morocco, covering a 21-year period and including 14 patients presenting histologically confirmed iatrogenic KD.

RESULTS:

Eight men and six women were included with a mean age of 56 years. All patients received corticosteroids, in combination with cyclophosphamide in three cases and with azathioprine in one case. The mean time to onset of lesions after the start of treatment was 16.5 months. The presentation in all cases was cutaneous. Impaired mucosal membrane was seen in 35.7% of patients, with visceral involvement being seen in only one patient. HIV serology tests were negative in all patients but HHV8 serology tests were positive in 78.5% of patients. Treatment consisted primarily of reduction or withdrawal of the immunosuppressant. The outcome was favourable in the majority of cases.

CONCLUSION:

In Morocco, KD is a rare but not exceptional complication of immunosuppressant therapy, particularly corticosteroids. The disease presented as a skin disorder in all of our patients, thus emphasising the value of regular follow-up and routine dermatological examination of patients on immunosuppressant therapy, and suggesting the value of screening for HHV8 infection before initiating such therapy.

• Authors: F E Lamchahab, I Tadlaoui, K Beqqal, T Bouattar, N Ouzeddoun, R Bayahia, M Ait Ourhroui, K Senouci, B Hassam, N Ismaili
• Journal: Annales de dermatologie et de venereologie (Ann Dermatol Venereol) Vol. 138 Issue 11 Pg. 729-35 (Nov 2011) ISSN: 0151-9638 [Print] France
• Vernacular Title: La maladie de Kaposi iatrogène au Maroc en dehors du contexte de la transplantation.
• PMID: 22078032 (Publication Type: English Abstract, Journal Article)
• Copyright: Copyright © 2011 Elsevier Masson SAS. All rights reserved.

Chemical References

• Adrenal Cortex Hormones
• Antibodies, Viral
• Immunosuppressive Agents
• Cyclophosphamide
• Azathioprine

Topics

• Adrenal Cortex Hormones (administration & dosage, adverse effects)
• Adult
• Aged
• Antibodies, Viral (blood)
• Azathioprine (administration & dosage, adverse effects)
• Cyclophosphamide (administration & dosage, adverse effects)
• Drug Therapy, Combination
• Female
• HIV Seronegativity
• Herpesvirus 8, Human (immunology, isolation & purification, physiology)
• Humans
• Iatrogenic Disease (epidemiology)
• Immunocompromised Host
• Immunosuppressive Agents (adverse effects)
• Male
• Middle Aged
• Morocco (epidemiology)
• Retrospective Studies
• Sarcoma, Kaposi (epidemiology, etiology)
• Skin Neoplasms (epidemiology, etiology)
• Virus Activation