[Kaposi sarcoma in Caucasian women. Clinical, chemical laboratory and endocrinologic studies in 8 women with HIV-associated or classical Kaposi sarcoma]

Abstract

Classic and HIV-associated Kaposi's sarcoma (KS) are predominantly found in male Caucasians. It is unclear why KS is so rare in women. At the Department of Dermatology, University of Frankfurt, epidemic KS was diagnosed in 299/751 (40%) male and 5/72 (18%) female HIV-infected patients. To detect common parameters regarding immunodeficiency, hormonal disturbances, abnormalities in clinical course, or sexual practices, data of eight women with KS (five HIV+, three HIV-) were compared. In HIV+ women KS is more aggressive than in HIV- women and more aggressive than in HIV+ men. Early and frequent visceral involvement and no preference for the lower extremities are found. Compared to HIV- women with KS, HIV+ women are generally younger (mean age 38 vs 71 years) and significantly immunodeficient (reduced absolute CD4 cell count and CD4/CD8 ratio). All women with KS investigated for sexual hormones (7/8) showed abnormalities: 7/7 had low oestrogens, 4/6 low LH and 3/5 low progesterone. Controls (n = 11, HIV+ without KS) showed a clear trend for higher serum levels of sexual hormones, but the difference was not significant. Although different reasons for low levels of oestrogens (drug abuse, marasmus, menopause) must be considered, the lack of oestrogens seems to be a common finding in HIV+ and HIV- women with KS. There was no correlation between sexual practices (anal or oral-faecal contacts) and the manifestation or aggressiveness of KS.