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. 2025 Jan 30;15(1):4737.
doi: 10.5826/dpc.1501a4737.

Propranolol: A Promising Therapeutic Avenue for Classic Kaposi Sarcoma

Rasha Mahmoud Genedy  1 , Marwa Owais  1 , Naglaa Mohamed El Sayed  1
Affiliations

Propranolol: A Promising Therapeutic Avenue for Classic Kaposi Sarcoma

Rasha Mahmoud Genedy et al. Dermatol Pract Concept. .

Abstract

Introduction: Kaposi sarcoma (KS) is a low grade angio-proliferative tumor of endothelial origin. Human herpesvirus 8 (HHV8) plays a major role in the pathogenesis of KS. Classic Kaposi sarcoma is commonly seen among elderly of Mediterranean origin. It is usually slowly progressive and is rarely fatal. There is no definitive cure for KS. Beta blockers were used with great success in the treatment of infantile hemangioma. Because of some similarity between infantile hemangioma and KS, topical beta blockers were tried with variable success rate.

Objectives: We aimed to assess the efficacy and safety of oral propranolol in the treatment of classic KS.

Methods: Fifteen patients diagnosed with classic KS were prospectively enrolled in the study. Detailed history and full clinical examination were conducted. Histopathological diagnosis with confirmatory immune staining was done for all patients. Oral propranolol in a dose of 60 mg was given per day for 6 months. The patients assessed clinically as complete responders, partial responders, and non-responders.

Results: Nine patients (60%) were partial responders; showed 50% reduction in the number of the existing lesions, and 6 patients (40%) were considered non-responders; 3 with stable disease and 3 with progressive disease. Lymphedema partially improved in 1 patient.

Conclusions: Oral propranolol is a safe and good option for treatment of patients with non-complicated classic KS, especially elderly with multiple comorbidities.

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Conflict of interest statement

Competing Interests: None.

Figures

Figure 1
Figure 1
Kaposi sarcoma (KS) histopathology, plaque stage. (A) Diffuse infiltrate occupying the upper and mid dermis (H&E ×100). (B) Higher magnification showing slit-like vascular spaces and extravasated red blood cells (RBCs), admixed with inflammatory cells (H&E ×400). KS nodular stage (C) the whole dermis is expanded with a solid nodule, with thinning of the overlying epidermis (H&E ×40). (D) Storiform pattern of the infiltrated spindle cells, extravasated RBCs (H&E ×100).
Figure 2
Figure 2
Immunohistochemical staining: (A) diffuse positive staining of both spindle cells and vascular spaces (D2-40 ×100) and (B) positive staining of the spindle cell nuclei for human herpes virus 8 (HHV8; ×400).
Figure 3
Figure 3
Clinical photo for a classic Kaposi sarcoma (CKS) patient (A) before treatment and (B) after treatment; more than 50% of the nodules faded, with more than 25% reduction in the size of the exophytic lesion.
Figure 4
Figure 4
Clinical photo for CKS on the right ankle (A) before treatment and (B) after treatment, evident reduction in the size of the nodules.
Figure 5
Figure 5
Clinical photo for CKS on the right leg (A) before treatment, and (B) after treatment; more than 90% of the nodules faded.
See this image and copyright information in PMC

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