This Article  • Full text  • PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Contact me when this article is cited  Related Content  • Related articles  • Similar articles in this journal  Topic Collections  • Dermatologic Disorders  • Bullous Diseases  • Pemphigus  • Drug Therapy  • Adverse Effects  • Immunologic Disorders  • Immunology, Other  • Alert me on articles by topic  Social Bookmarking   What's this?

Sarika Saggar, MD; Joshua A. Zeichner, MD; Tamu T. Brown, MD; Robert G. Phelps, MD; Steven R. Cohen, MD, MPH

Arch Dermatol. 2008;144(5):654-657.

Background  Iatrogenic Kaposi’s sarcoma (KS) has been reported in patients who use immunosuppressive regimens for the treatment of autoimmune disorders, malignant neoplasms, and organ transplant rejection. However, iatrogenic KS in the setting of pemphigus vulgaris (PV) has been infrequently observed. The conventional treatment strategy for iatrogenic KS has focused on reducing immunosuppression, which carries a poor prognosis owing to a substantial risk for exacerbation of the primary disease.

Observations  A 49-year-old man developed KS on his wrist after 2 years of long-term immunosuppressive therapy with prednisone, methotrexate, and dapsone for well-controlled PV. Three months after the substitution of methotrexate with sirolimus, the KS gradually resolved. With the patient on a maintenance regimen of sirolimus, in conjunction with low-dose prednisone and dapsone therapy, KS and PV have remained in remission, without further recurrence, during a 24-month follow-up period.

Conclusion  The present case introduces a novel therapy for this patient population, highlighting the efficacy of sirolimus in treating iatrogenic KS without sacrificing the immunosuppression necessary to maintain control of PV.

Author Affiliations: Division of Dermatology, Department of Medicine, Albert Einstein College of Medicine, Bronx, New York (Drs Saggar, Brown, and Cohen); and Department of Dermatology, Mount Sinai Medical Center, New York, New York (Drs Zeichner and Phelps).

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

RELATED ARTICLES

Lymphatic Mapping and Sentinel Node Biopsy: The Data Unclouded by Speculation
Alistair J. Cochran and John F. Thompson
Arch Dermatol. 2008;144(5):687-688.
EXTRACT | FULL TEXT  

Lymphatic Mapping and Sentinel Node Biopsy: The Data Unclouded by Speculation—Reply
Matthew H. Kanzler
Arch Dermatol. 2008;144(5):688-689.
EXTRACT | FULL TEXT  

Classic Mediterranean Kaposi’s Sarcoma Regression With Sirolimus Treatment
Emmanuella Guenova, Gisela Metzler, Wolfram Hoetzenecker, Mark Berneburg, and Martin Rocken
Arch Dermatol. 2008;144(5):692-693.
EXTRACT | FULL TEXT