Case #11 Discussion

Summary: This is a pigmented, localized, intravascular surface lesion:   ~Pigmented – it is a localized blue-purple lesion   ~Intravascular lesion – blanches upon pressure Lesions to Exclude from the Differential Diagnosis: Hemangioma   ~Has not been present since birth or early childhood Varix   ~Typically not this large Lesions to Include in the Differential Diagnosis: Kaposi’s Sarcoma   ~Presence of multiple vascular lesions   ~Lymphadenopathy is present Management: The presence of multiple vascular lesions consistent with Kaposi’s sarcoma in a patient with persistent lymphadenopathy is suggestive of HIV/AIDS or other immunocompromised state.  Explain to the patient the cause and nature of the lesion and that it is almost always seen in immunosuppressed individuals.  Explain that if the patient has HIV, these lesions indicate that the disease has progressed to AIDS.  If there is any chance the patient has HIV, urge them to consider safe sex and contacting all sexual partners who they may have infected so they can check their own HIV status and practice safe sex.  Refer the patient to a physician. Final Diagnosis: Kaposi's Sarcoma