Kaposi sarcoma in human immunodeficiency virus infection, clinicopathologic correlation with coexisting patch and plaque stage features: A case report and review of literature

doi:10.12998/wjcc.121686

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World Journal of Clinical Cases

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2307-8960

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

Case Report

Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.

World J Clin Cases. Jun 26, 2026; 14(18): 121686
Published online Jun 26, 2026. doi: 10.12998/wjcc.121686

Kaposi sarcoma in human immunodeficiency virus infection, clinicopathologic correlation with coexisting patch and plaque stage features: A case report and review of literature

Khadeja Alrefaie, Al-Sadat Mosbeh, Abeer Albazali

Khadeja Alrefaie, Department of Training, Kuwait Institute for Medical Specializations, Sulibekhat 13018, Kuwait

Al-Sadat Mosbeh, Abeer Albazali, Department of Dermatology, Al-Farwaniyah Hospital, Farwaniya 81004, Kuwait

Al-Sadat Mosbeh, Department of Dermatology and Venereology, Faculty of Medicine, Al-Azhar University, Cairo 11884, Egypt

Co-first authors: Khadeja Alrefaie and Al-Sadat Mosbeh.

Author contributions: Alrefaie K conceived and designed the study, performed the literature review, analyzed and interpreted the clinical and histopathologic data, and drafted the manuscript; Mosbeh AS was the primary treating physician who diagnosed and managed the patient, obtained the clinical history, provided the clinical materials, and follow-up data, prepared the figures, and contributed substantially to the interpretation of clinical and histopathological findings and revision of the manuscript; Albazali A supervised the study, provided senior academic guidance and methodological oversight, contributed to critical revision of the manuscript for scientific accuracy and clarity, and approved the final version for publication; and all authors reviewed, approved, and agreed to be accountable for the content of the manuscript. Alrefaie K and Mosbeh AS contributed equally in complementary leadership roles, with one leading the scientific conception and manuscript preparation and the other leading the clinical diagnosis and patient management; therefore, they share the first authorship; Alrefaie K coordinated all stages of manuscript development, revised the text critically for important intellectual content, and serves as the corresponding author responsible for communication with the journal.

AI contribution statement: ChatGPT was used only for grammar correction, language polishing, and improving clarity of wording. No portion of the manuscript text, figures, tables, study design, clinical interpretation, or conclusions was generated by AI. The authors reviewed and approved all manuscript content and take full responsibility for the work.

Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.

Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.

CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).

Corresponding author: Khadeja Alrefaie, MD, Department of Training, Kuwait Institute for Medical Specializations, Jamal Abdulnaser Street, Sulibekhat 13018, Kuwait. alhoussani6078@moh.gov.kw

Received: March 31, 2026
Revised: May 3, 2026
Accepted: May 25, 2026
Published online: June 26, 2026
Processing time: 77 Days and 5.8 Hours

Abstract

BACKGROUND

Kaposi sarcoma (KS) is a human herpesvirus 8 (HHV-8)-associated vascular neoplasm frequently linked to advanced human immunodeficiency virus (HIV) infection and may clinically mimic several inflammatory, vascular, and melanocytic disorders. Early recognition is essential, as cutaneous lesions may represent the first indicator of undiagnosed immunosuppression. We report this case to emphasize the diagnostic value of overlapping histopathological features and clinicopathologic correlation in differentiating KS from its clinical mimickers.

CASE SUMMARY

A 45-year-old man presented with a 6-month history of progressively increasing violaceous papules and plaques on the abdomen and chest. Initial differential diagnoses included vascular, granulomatous, and melanocytic conditions. Skin biopsy revealed epidermal atrophy, elongation of rete ridges, dermal vascular proliferation, slit-like vascular spaces, spindle-cell proliferation, plasma-cell infiltrates, and extravasated erythrocytes, demonstrating coexisting histopathologic features of patch and plaque stage KS. Immunohistochemistry showed strong nuclear positivity for HHV-8 latent nuclear antigen-1, confirming the diagnosis. Subsequent testing identified previously undiagnosed HIV infection with a low CD4 count. Combination antiretroviral therapy was initiated, resulting in partial clinical regression of the lesions on follow-up.

CONCLUSION

Cutaneous KS may serve as an early indicator of occult HIV infection. Timely biopsy and HHV-8 confirmation enable early diagnosis and prompt initiation of antiretroviral therapy, thereby improving clinical outcomes.

Keywords: Kaposi sarcoma; Human herpesvirus 8; Latent nuclear antigen-1; Human immunodeficiency virus; Vascular tumors; Dermatopathology; Case report

Core Tip: Kaposi sarcoma may be the first clinical indicator of previously undiagnosed human immunodeficiency virus infection. This case demonstrates the coexisting histopathologic features of patch and plaque stages within a single biopsy specimen, highlighting key diagnostic features such as slit-like vascular spaces, spindle-cell proliferation, and confirmatory human herpesvirus 8 latent nuclear antigen-1 positivity. Recognition of these clinicopathological features is essential for differentiating Kaposi sarcoma from its mimickers and enables timely human immunodeficiency virus testing and early initiation of antiretroviral therapy, which may lead to lesion regression and improved clinical outcomes.