Oral Kaposi's sarcoma in a patient with the acquired immune deficiency syndrome. A case report with notes on management and safety.

Dental practitioners may be the 1st to identify signs of acquired immunodeficiency syndrome (AIDS) given the tendency for this disease to manifest with a number or oral lesions. This paper presents the case of a white homosexual man from South Africa with oral Kaposis sarcoma and suggests guidelines for the management by dentists of AIDS patients. Lesions of Kaposis sarcoma in the mouth tend to be located on the palate and the gingiva and appear as multifocal macules plaques or nodules with a reddish or dark blue/purple coloration. The patient whose case is presented had 2 lesions on the hard palate and 2 red oval macules on the soft palate as well as a plaque-like lesion on the buccal gingiva of the maxilla. Specimens from these sites consisted of vascular lesions with a proliferation of spindle-shaped cells in the submucosa. The patient also experienced repeated episodes of oral candidiasis. In their early stages the oral manifestations of Kaposis sarcoma may be mistaken for a nonspecific inflammation or a granulomatous lesion. Once mature lesions of Kaposis sarcoma may resemble hematomas other vascular tumors or malignant melanomas. Dentists who suspect that a patients oral lesion are AIDS-associated should make an immediate referral for further testing. Although there is no justification for dentists to refuse to treat patients with AIDS precautions should be taken. These include wearing surgical gloves and gown prompt cleaning with a disinfectant of all blood spills destruction on needles used for anesthesia sterilization of all instruments and equipment after use labelling of any specimens taken with "AIDS precaution" and treatment in a separate surgery.