A juvenile case of classic Kaposi's sarcoma.

A 13-year-old boy was admitted to our dermatology outpatient clinic with red to brown macules on his legs and arms. He had had violaceous to red macules on his legs and feet and similar lesions on his arms 1 year before admission. Apart from these complaints, there were no important features in his history or his family history. On dermatological examination, numerous brownish-red patches, 10 ± 30 mm in diameter, of variable shape were seen on his legs and arms (Figs. 1 and 2). The patches were slightly indurated with thin squams. In addition, there were a few violaceous ± red macules, 30 ± 50 mm in diameter, with sharp borders and of various shapes on the soles of his feet and toes. The oral mucosa, ®ngernails and toenails were of normal appearance. Multiple lymphadenomegaly in the cervical and submandibular regions and 3 ± 5 lymhadenomegaly, which were mobile and painless, were detected in both the axillary and the inguinal regions. Inguinal biopsy showed reactive lymph nodes. Other organ system examinations were evaluated as normal. There was no pathology in laboratory parameters (complete blood count, urinalysis, blood biochemistry, erythrocyte sedimentation rate, VDRL, TPHA or HIV). HHV-8 was found to be negative by PCR. Chest X-ray, abdominal ultrasound graphics and oesophageal, gastric, duodenal and colon contrast graphics were evaluated as normal. A skin biopsy specimen was taken from the lesion near the left ankle. There was widespread in ̄ammatory mononuclear cell in®ltration and prominent vascular proliferation in the medium and upper dermis. The histopathological picture corresponded with late macular stage of KS (Figs. 3 and 4). Intralesional vinblastine (0.1 ml/cm2) was applied as therapy and the patient exhibited a good response. We continue to follow-up the patient at regular periods.