Kaposi's sarcoma physical examination: Difference between revisions

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__NOTOC__
__NOTOC__
{{CMG}}
{{CMG}};{{AE}} {{KS}}{{ADS}}
{{Kaposi's sarcoma}}
{{Kaposi's sarcoma}}
==Overview==
==Overview==
Kaposi's sarcoma [[lesion]]s are nodules or patches that may be purple, red, blue, or black in color and are usually located on the nose, legs, and feet.
==Physical Examination==
==Physical Examination==
KS [[lesion]]s are nodules or blotches that may be red, purple, brown, or black, and are usually '''papular''' (ie palpable or raised).
===General Appearance===
[[Image:Kaposi's Sarcoma.jpg|thumb|left|Papular cutaneous Kaposi's Sarcoma]][[Image:Kaposi’s sarcoma intraoral AIDS 072 lores.jpg|thumb|200px|left]]
Patients with Kaposi's sarcoma usually appear fatigued
They are typically found on the skin, but spread elsewhere is common, especially the mouth, [[gastrointestinal tract]] and [[respiratory tract]]. Growth can range from very slow to explosively fast, and be associated with significant [[mortality]] and [[morbidity]].<ref>{{cite journal |last=Dezube |first=BJ |authorlink= |coauthors= |year=1996 |month=Oct |title=Clinical presentation and natural history of AIDS--related Kaposi's sarcoma |journal=Hematol Oncol Clin North Am |volume=10 |issue=5 |pages=1023-9 |id= |url=http://www.ncbi.nlm.nih.gov/sites/entrez?cmd=Retrieve&db=PubMed&list_uids=8880194&dopt=Citation |accessdate= |quote= }}</ref>


'''Skin'''
===Skin===
Kaposi's sarcoma [[lesion]]s are nodules or patches that may be purple, red, blue, or black in color and are usually located on the nose, legs, and feet.


The skin lesions most commonly affect the lower limbs, face, mouth and [[genitalia]]. The lesions are usually as described above, but may occasionally be [[plaque]] like (often on the soles of the feet) or even involved in skin breakdown with resulting '''fungating''' lesions.
===HEENT===
Associated swelling may be from either local [[inflammation]] or [[lymphoedema]] (obstruction of local [[lymphatic vessels]] by the lesion). Skin lesions may be quite disfiguring for the sufferer, and a cause of much psychosocial pathology.  
The oral cavity is involved in about 30%, and is the initial site in 15% of AIDS related Kaposi's sarcoma. In the mouth, the [[hard palate]] is most frequently affected, followed by the [[gums]] <ref>{{cite journal |last=Nichols |first=CM |authorlink= |coauthors= |year=1993 |month=Nov |title=Treating Kaposi's lesions in the HIV-infected patient. |journal=J Am Dent Assoc |volume=124 |issue=11 |pages=78-84 |id= |url=http://jada.ada.org/cgi/content/abstract/124/11/78 |accessdate= 2007-06-11 |quote= }}</ref>. Lesions in the mouth may be easily damaged by chewing and bleed or suffer secondary infection, and even interfere with eating or speaking.
<br clear="left"/>


'''Mouth'''
===Extremities===


Is involved in about 30%, and is the initial site in 15% of AIDS related KS. In the mouth, the [[hard palate]] is most frequently affected, followed by the [[gums]] <ref>{{cite journal |last=Nichols |first=CM |authorlink= |coauthors= |year=1993 |month=Nov |title=Treating Kaposi's lesions in the HIV-infected patient. |journal=J Am Dent Assoc |volume=124 |issue=11 |pages=78-84 |id= |url=http://jada.ada.org/cgi/content/abstract/124/11/78 |accessdate= 2007-06-11 |quote= }}</ref>. Lesions in the mouth may be easily damaged by chewing and bleed or suffer secondary infection, and even interfere with eating or speaking.
<gallery>


'''Gastrointestinal tract'''
Image:Kaposi's sarcoma01.jpg|Kaposi's sarcoma. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/ Adapted from Dermatology Atlas.]''<ref name="Dermatology Atlas">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/}}</ref></SMALL></SMALL>
Image:Kaposi's sarcoma02.jpg|Kaposi's sarcoma. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/ Adapted from Dermatology Atlas.]''<ref name="Dermatology Atlas">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/}}</ref></SMALL></SMALL>
Image:Kaposi's sarcoma03.jpg|Kaposi's sarcoma. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/ Adapted from Dermatology Atlas.]''<ref name="Dermatology Atlas">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/}}</ref></SMALL></SMALL>
Image:Kaposi's sarcoma04.jpg|Kaposi's sarcoma. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/ Adapted from Dermatology Atlas.]''<ref name="Dermatology Atlas">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/}}</ref></SMALL></SMALL>
Image:Kaposi's sarcoma05.jpg|Kaposi's sarcoma. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/ Adapted from Dermatology Atlas.]''<ref name="Dermatology Atlas">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/}}</ref></SMALL></SMALL>
Image:Kaposi's sarcoma06.jpg|Kaposi's sarcoma. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/ Adapted from Dermatology Atlas.]''<ref name="Dermatology Atlas">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/}}</ref></SMALL></SMALL>
Image:Kaposi's sarcoma07.jpg|Kaposi's sarcoma. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/ Adapted from Dermatology Atlas.]''<ref name="Dermatology Atlas">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/}}</ref></SMALL></SMALL>
Image:Kaposi's sarcoma08.jpg|Kaposi's sarcoma. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/ Adapted from Dermatology Atlas.]''<ref name="Dermatology Atlas">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/}}</ref></SMALL></SMALL>
Image:Kaposi's sarcoma09.jpg|Kaposi's sarcoma. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/ Adapted from Dermatology Atlas.]''<ref name="Dermatology Atlas">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/}}</ref></SMALL></SMALL>
Image:Kaposi's sarcoma10.jpg|Kaposi's sarcoma. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/ Adapted from Dermatology Atlas.]''<ref name="Dermatology Atlas">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/}}</ref></SMALL></SMALL>
Image:Kaposi's sarcoma11.jpg|Kaposi's sarcoma. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/ Adapted from Dermatology Atlas.]''<ref name="Dermatology Atlas">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/}}</ref></SMALL></SMALL>
Image:Kaposi's sarcoma12.jpg|Kaposi's sarcoma. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/ Adapted from Dermatology Atlas.]''<ref name="Dermatology Atlas">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/}}</ref></SMALL></SMALL>
Image:Kaposi's sarcoma13.jpg|Kaposi's sarcoma. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/ Adapted from Dermatology Atlas.]''<ref name="Dermatology Atlas">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/}}</ref></SMALL></SMALL>
Image:Kaposi's sarcoma14.jpg|Kaposi's sarcoma. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/ Adapted from Dermatology Atlas.]''<ref name="Dermatology Atlas">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/}}</ref></SMALL></SMALL>
Image:Kaposi's sarcoma15.jpg|Kaposi's sarcoma. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/ Adapted from Dermatology Atlas.]''<ref name="Dermatology Atlas">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/}}</ref></SMALL></SMALL>
Image:Kaposi's sarcoma16.jpg|Kaposi's sarcoma. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/ Adapted from Dermatology Atlas.]''<ref name="Dermatology Atlas">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/}}</ref></SMALL></SMALL>
Image:Kaposi's sarcoma17.jpg|Kaposi's sarcoma. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/ Adapted from Dermatology Atlas.]''<ref name="Dermatology Atlas">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/}}</ref></SMALL></SMALL>
Image:Kaposi's sarcoma18.jpg|Kaposi's sarcoma. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/ Adapted from Dermatology Atlas.]''<ref name="Dermatology Atlas">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/}}</ref></SMALL></SMALL>
Image:Kaposi's sarcoma19.jpg|Kaposi's sarcoma. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/ Adapted from Dermatology Atlas.]''<ref name="Dermatology Atlas">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/}}</ref></SMALL></SMALL>
Image:Kaposi's sarcoma20.jpg|Kaposi's sarcoma. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/ Adapted from Dermatology Atlas.]''<ref name="Dermatology Atlas">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/}}</ref></SMALL></SMALL>
Image:Kaposi's sarcoma21.jpg|Kaposi's sarcoma. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/ Adapted from Dermatology Atlas.]''<ref name="Dermatology Atlas">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/}}</ref></SMALL></SMALL>
Image:Kaposi's sarcoma22.jpg|Kaposi's sarcoma. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/ Adapted from Dermatology Atlas.]''<ref name="Dermatology Atlas">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/}}</ref></SMALL></SMALL>
Image:Kaposi's sarcoma23.jpg|Kaposi's sarcoma. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/ Adapted from Dermatology Atlas.]''<ref name="Dermatology Atlas">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/}}</ref></SMALL></SMALL>
Image:Kaposi's sarcoma24.jpg|Kaposi's sarcoma. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/ Adapted from Dermatology Atlas.]''<ref name="Dermatology Atlas">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/}}</ref></SMALL></SMALL>
Image:Kaposi's sarcoma25.jpg|Kaposi's sarcoma. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/ Adapted from Dermatology Atlas.]''<ref name="Dermatology Atlas">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/}}</ref></SMALL></SMALL>
Image:Kaposi's sarcoma26.jpg|Kaposi's sarcoma. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/ Adapted from Dermatology Atlas.]''<ref name="Dermatology Atlas">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/}}</ref></SMALL></SMALL>
Image:Kaposi's sarcoma27.jpg|Kaposi's sarcoma. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/ Adapted from Dermatology Atlas.]''<ref name="Dermatology Atlas">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/}}</ref></SMALL></SMALL>
Image:Kaposi's sarcoma28.jpg|Kaposi's sarcoma. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/ Adapted from Dermatology Atlas.]''<ref name="Dermatology Atlas">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/}}</ref></SMALL></SMALL>
Image:Kaposi's sarcoma29.jpg|Kaposi's sarcoma. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/ Adapted from Dermatology Atlas.]''<ref name="Dermatology Atlas">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/}}</ref></SMALL></SMALL>
Image:Kaposi's sarcoma30.jpg|Kaposi's sarcoma. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/ Adapted from Dermatology Atlas.]''<ref name="Dermatology Atlas">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/}}</ref></SMALL></SMALL>
Image:Kaposi's sarcoma31.jpg|Kaposi's sarcoma. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/ Adapted from Dermatology Atlas.]''<ref name="Dermatology Atlas">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/}}</ref></SMALL></SMALL>
Image:Kaposi's sarcoma32.jpg|Kaposi's sarcoma. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/ Adapted from Dermatology Atlas.]''<ref name="Dermatology Atlas">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/}}</ref></SMALL></SMALL>
Image:Kaposi's sarcoma33.jpg|Kaposi's sarcoma. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/ Adapted from Dermatology Atlas.]''<ref name="Dermatology Atlas">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/}}</ref></SMALL></SMALL>
Image:Kaposi's sarcoma34.jpg|Kaposi's sarcoma. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/ Adapted from Dermatology Atlas.]''<ref name="Dermatology Atlas">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/}}</ref></SMALL></SMALL>
Image:Kaposi's sarcoma35.jpg|Kaposi's sarcoma. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/ Adapted from Dermatology Atlas.]''<ref name="Dermatology Atlas">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/}}</ref></SMALL></SMALL>
Image:Kaposi's sarcoma36.jpg|Kaposi's sarcoma. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/ Adapted from Dermatology Atlas.]''<ref name="Dermatology Atlas">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/}}</ref></SMALL></SMALL>
Image:Kaposi's sarcoma37.jpg|Kaposi's sarcoma. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/ Adapted from Dermatology Atlas.]''<ref name="Dermatology Atlas">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/}}</ref></SMALL></SMALL>
Image:Kaposi's sarcoma38.jpg|Kaposi's sarcoma. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/ Adapted from Dermatology Atlas.]''<ref name="Dermatology Atlas">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/}}</ref></SMALL></SMALL>
Image:Kaposi's sarcoma39.jpg|Kaposi's sarcoma. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/ Adapted from Dermatology Atlas.]''<ref name="Dermatology Atlas">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/}}</ref></SMALL></SMALL>
Image:Kaposi's sarcoma40.jpg|Kaposi's sarcoma. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/ Adapted from Dermatology Atlas.]''<ref name="Dermatology Atlas">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/}}</ref></SMALL></SMALL>
Image:Kaposi's sarcoma41.jpg|Kaposi's sarcoma. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/ Adapted from Dermatology Atlas.]''<ref name="Dermatology Atlas">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/}}</ref></SMALL></SMALL>
Image:Kaposi's sarcoma42.jpg|Kaposi's sarcoma. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/ Adapted from Dermatology Atlas.]''<ref name="Dermatology Atlas">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/}}</ref></SMALL></SMALL>
Image:Kaposi's sarcoma43.jpg|Kaposi's sarcoma. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/ Adapted from Dermatology Atlas.]''<ref name="Dermatology Atlas">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/}}</ref></SMALL></SMALL>


Involvement can be common in those with transplant related or AIDS related KS, and it may occur in the absence of skin involvement. The gastrointestinal lesions may be silent or cause weight loss, pain, nausea/vomiting, [[diarrhea]], bleeding (either vomiting blood or passing it with bowel motions), [[malabsorption]], or [[intestinal obstruction]].<ref>{{cite journal |last=Danzig |first=JB |authorlink= |coauthors= |year=1991 |month=Jun |title=Gastrointestinal malignancy in patients with AIDS |journal=Am J Gastroenterol  |volume=86 |issue=6 |pages=715-8 |id= |url=http://www.ncbi.nlm.nih.gov/sites/entrez?cmd=Retrieve&db=PubMed&list_uids=2038993&dopt=Citation |accessdate= 2007-06-11 |quote= }}</ref>
</gallery>


'''Respiratory tract'''
==References==
 
{{reflist|2}}
Involvement of the airway can present with shortness of breath, [[fever]], [[cough]], [[hemoptysis]] (coughing up blood), or chest pain, or as an incidental finding on [[chest x-ray]].<ref>{{cite journal |last=Garay |first=SM |authorlink= |coauthors= |year=1987 |month=Jan |title=Pulmonary manifestations of Kaposi's sarcoma |journal=Chest |volume=91 |issue=1 |pages=39-43 |id= |url=http://www.chestjournal.org/cgi/reprint/91/1/39 |accessdate= 2007-06-11 |quote= }}</ref> The diagnosis is usually confirmed by [[bronchoscopy]] when the lesions are directly seen, and often biopsied.


==References==
{{Reflist|2}}
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Latest revision as of 14:23, 27 March 2019

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Kiran Singh, M.D. [2]Amandeep Singh M.D.[3]

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Overview

Kaposi's sarcoma lesions are nodules or patches that may be purple, red, blue, or black in color and are usually located on the nose, legs, and feet.

Physical Examination

General Appearance

Patients with Kaposi's sarcoma usually appear fatigued

Skin

Kaposi's sarcoma lesions are nodules or patches that may be purple, red, blue, or black in color and are usually located on the nose, legs, and feet.

HEENT

The oral cavity is involved in about 30%, and is the initial site in 15% of AIDS related Kaposi's sarcoma. In the mouth, the hard palate is most frequently affected, followed by the gums [1]. Lesions in the mouth may be easily damaged by chewing and bleed or suffer secondary infection, and even interfere with eating or speaking.

Extremities

References

  1. ↑ Nichols, CM (1993). "Treating Kaposi's lesions in the HIV-infected patient". J Am Dent Assoc. 124 (11): 78–84. Retrieved 2007-06-11. Unknown parameter |month= ignored (help)
  2. ↑ 2.00 2.01 2.02 2.03 2.04 2.05 2.06 2.07 2.08 2.09 2.10 2.11 2.12 2.13 2.14 2.15 2.16 2.17 2.18 2.19 2.20 2.21 2.22 2.23 2.24 2.25 2.26 2.27 2.28 2.29 2.30 2.31 2.32 2.33 2.34 2.35 2.36 2.37 2.38 2.39 2.40 2.41 2.42 "Dermatology Atlas".

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