Terapia topica con Imiquimod crema del sarcoma di Kaposi stadio in chiazza: studio di un caso

Kaposi’s sarcoma (KS) is an angioproliferative, chronic disease induced by HSV-8, a member of Gammaherpes viridae family. Cutaneous lesions of SK are usually red to purple macules/plaque and nodules that can ulcerate with blood flow and pain. Precocious diagnosis and treatment are important to prevent or minimizing more serious symptoms. We present a case-report of a 82 years old man affected by classic SK and other co-morbidity (diabetes, hypertension, B hepatitis). From 2005 he is in treatment for KS disease: he had surgical removal of multiple lesions (plaques and nodules) of his legs and arms. From 2008 nodular, acral lesions were treated with intralesional vinblastine (0.5 mg/ml), with complete or partial regression. In 2005 he also had a surgical removal of a squamous cell carcinoma of pre-auricular right region and in 2006 he had another surgical removal of a squamous cell carcinoma of his right ear. In 2007, actinic keratosis localized on right ear and face were treated with Imiquimod 5% cream 1 time per day for 5 days/week; because patches of KS lesion were present adjacent to them, we decided to treat all these lesions (KS and keratosis) with a progressive regression of every lesions within three months. Recent studies demonstrate that SK is responsive to intralesional, low-doses, INF-alpha weekly therapy in 70% of cases; because Imiquimod can induce epidermal release of INF-alpha, an anti-viral and anti-angiogenetic activity has been proven. In conclusion, Imiquimod could be a new therapeutical chance for KS lesions, patch stage, smaller than 1 cm.