Naslov
Kaposi sarcoma in HIV-positive patient with psoriasis

Autori
Romih Pintar, Vanja ; Vrsaljko, Nina ; Atelj, Anita ; Zekan, Šime ; Lukas, Davorka ; Begovac, Josip

Vrsta, podvrsta i kategorija rada
Sažeci sa skupova, sažetak, znanstveni

Skup
3rd South-East European Conference on Travel, Tropical, Migration Medicine and HIV and 4th Croatian Congress on Travel, Tropical, Migration Medicine & HIV

Mjesto i datum
Zadar, Hrvatska, 16.09.2021. - 19.09.2021

Vrsta sudjelovanja
Poster

Vrsta recenzije
Domaća recenzija

Ključne riječi
Kaposi sarcoma ; HIV-positive patient ; psoriasis

Sažetak
A 56-year-old HIV positive patient was admitted to our hospital because of weight loss, prolonged productive cough with nodular pulmonary infiltrates on his chest X-ray and skin lesions. The patient was diagnosed with HIV in 2010. Antiretroviral therapy was initiated and patient was virally suppressed up until his last follow-up visit in 2016 when he decided to stop taking ART. In 2016 he developed severe psoriasis which was never confirmed via skin biopsy and was treated with topical therapy. Between June and October 2019. he received methotrexate with short-term success followed by worsening of symptoms. He also noticed a growing livid skin lesion on his nose. His clinical and family history were otherwise unremarkable. In his clinical status upon admission patient had diffuse red maculopapular skin lesions with squamous and hemorrhagic components on his chest, back and extremities. Also, there were two raised livid lesions on his nose and soft palate and small livid lesions on the back. His HIV status was evaluated and CD4+ lymphocyte count was 5/μl (0, 6%) indicating severe immunodeficiency, with viral load of 406 000 copies/ml. Serum serologic tests were negative for acute infection with T. pallidum, CMV, EBV, T. gondii and viral hepatitis. Quantiferon test was negative. Chest MSCT showed bilateral nodular lesions highly indicative of Kaposi sarcoma. There was no pathology found via bronchoscopy, however PCR for Pneumocystis jirovecii from bronchoalveolar lavage came back positive. Skin biopsy confirmed the diagnosis of psoriasis. Antiretroviral therapy was initiated (abacavir/3TC/dolutegravir) and pneumocystis was treated with trimethoprim/sulfamethoxazole. During hospitalization, patient received two courses of chemotherapy with liposomal doxorubicin and was discharged after 4 weeks. Between December 2019. and April 2020. he received in total 8 courses of chemotherapy after which he showed clinical improvement and regression of not only pulmonary lesions but also psoriasis and nodular skin lesions.

Izvorni jezik
Engleski

Znanstvena područja
Kliničke medicinske znanosti

POVEZANOST RADA