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Kaposi’s sarcoma: case report A 49-year-old man developed Kaposi’s sarcoma while receiving methotrexate and prednisone for pemphigus vulgaris. About 2 years previously, the man had started receiving oral prednisone 60 mg/day. Sodium aurothiomalate was subsequently added. Over the next 3 months, the prednisone dosage was gradually tapered to 7.5 mg/day. After more than 1 year, the dosage was transiently increased to 20 mg/day for an exacerbation, and oral methotrexate 7.5 mg/week in three divided doses was added. Gradually, the methotrexate dosage was increased to 12.5 mg/week. After 6 months, dapsone was added; at this time, his prednisone dosage was 7.5 mg/day. Subsequently, he developed an isolated erythematous patch surrounded by haemorrhagic papules on his left forearm. The man’s prednisone dosage was increased to 15 mg/day, and he received intralesional triamcinolone and IV rituximab. The patch thickened into a firm haemorrhagic annular plaque. Biopsy findings were diagnostic of patch-stage Kaposi’s sarcoma. Cryosurgery was started. Methotrexate was discontinued. He continued to received prednisone 15 mg/day, dapsone and sodium aurothiomalate. After 1 month, palpation of the lesion revealed increasing induration. He started receiving oral sirolimus. During the first month, dramatic involution of the plaque occurred. By month 3, it was virtually imperceptible. Over the next 2 years, there was no recurrence of Kaposi’s sarcoma. Saggar S, et al. Kaposi’s sarcoma resolves after sirolimus therapy in a patient with pemphigus vulgaris. Archives of Dermatology 144: 654-657, No. 5, May 2008 801111210 USA

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Reactions 31 May 2008 No. 1204