Multifocal Kaposi's sarcoma mimicking allergic vasculitis.

Sir, Kaposi’s sarcoma (KS) is a multifocal neoplastic process occurring predominantly in the dermal vasculature (1, 2). Bluish-red macules, plaques and tumours characterize the neoplasm, which most commonly affects the feet (1 – 3). The recognized clinical variants of KS include classic KS, endemic African KS, KS in iatrogenically immunocompromised patients and HIVassociated KS (1, 4). The discovery of herpes-virus-like DNA in all variants of KS supports a theory of viral aetiology for this neoplasm (3, 5, 6). The clinical course of KS in iatrogenically immunocompromised patients is similar to that of the classic KS, e.g. it is characterized by slow progression and predominantly benign course, but may be more aggressive in the case of continued immunosuppression (3). We report the case of a woman with corticosteroidtreated rheumatoid arthritis who presented with bilateral palpable purpura-like eruption on the dorsal feet initially diagnosed as hypersensitivity vasculitis. Her skin biopsy made 2 years later demonstrated typical histological signs of KS.