¹Resident in Internal Medicine Training, Department of Internal Medicine, Unidade Local de Saúde do Oeste – Hospital Caldas da Rainha, Caldas da Rainha, Portugal; ORCID: https://orcid.org/0000- 0001-9503-7049

²Senior Consultant in Internal Medicine, Casa Santa Maria (RNCCI/ERPI), Lisboa, Portugal; ORCID: https://orcid.org/0000-0003-4448-4169

Corresponding Author: Sara Lourenço Tereso, ORCID: https://orcid.org/0000- 0001-9503-7049, Rua Diário de Notícias, 2500-176, Caldas da Rainha, Portugal.

Citation: Sara Tereso, Carlos Machado e Costa (2026). Iatrogenic Cutaneous Kaposi Sarcoma Associated with Chronic Corticosteroid Therapy. Euro J Case Rep Clin Imag. 2026; August, e22,1-3.

Copyrights © Sara Lourenço Tereso, 2026, et al., This article is licensed under the Creative Commons Attribution-Non Commercial-4.0-International-License-(CCBY-NC) (https://europeanjournalofcasereports.org/blogpage/copyright-policy ). Usage and distribution for commercial purposes require written permission.

Image Case Presentation:

A 76‑year‑old man with polymyalgia rheumatica on prednisolone presented with erythematous‑violaceous maculopapules on the lower limbs, which did not blanch on digital pressure, were non‑pruritic, non‑bleeding and painless, under outpatient follow‑up. Due to an increase in the number of these lesions on the lower limbs, with extension to the left upper limb (Figures 1 and 2), reaching a maximum diameter of 2 cm, hospital observation was warranted. Physical examination revealed no mucosal involvement and no palpable lymphadenopathies. Laboratory tests showed negative serologies for HIV, EBV, syphilis and hepatitis B/C, excluding other causes of immunodeficiency. Cervical, thoracic, abdominal and pelvic computed tomography revealed no abnormalities. Skin biopsy demonstrated a perivascular lymphocytic infiltrate with scattered plasma cells in the dermis and proliferation of irregular and asymmetric blood vessels. Immunohistochemistry was positive for human herpesvirus type 8 (HHV‑8). Based on the clinical and histological findings, and after excluding differential diagnoses, a diagnosis of iatrogenic cutaneous Kaposi’s sarcoma in the context of chronic corticosteroid therapy was established. Corticosteroid therapy was reduced, with improvement and progressive regression of the lesions. Kaposi’s sarcoma is a rare angioproliferative tumour, [1,2] typically cutaneous, [3] with either indolent or aggressive behaviour, in which HHV‑8 plays a central role in its pathogenesis [1,3,4] and can be detected in all its variants [4]. HHV‑8, associated with states of immunosuppression such as rheumatological disease treated with corticosteroids, may induce Kaposi’s sarcoma [4,5]. Lesions may range from macules and plaques to violaceous exophytic tumours, [1,2] potentially invading adjacent tissues, and discontinuation of the immunosuppressive drug is recommended [5].

Declarations:

Funding: This research received no external funding.

Institutional Review Board Statement: Not applicable.

Informed Consent Statement: Informed consent for publication was obtained from the patient’s legal guardians.

Data Availability Statement: No new data were created or analyzed in this study. Data sharing is not applicable to this article.

Acknowledgments: Not applicable.

Conflicts of Interest: We confirm that there are no conflicts of interest to declare.

Reference:

1. Vangipuram R, Tyring S K. Epidemiology of Kaposi sarcoma: review and description of the nonepidemic variant. International jornal of dermatology. 2019 May, 58: 538-542. DOI: 10.1111/ijd.14080.

2. Amaral I, Soares I, Correia MP, Abreu IT, Monteiro F, Antunes J et al. Kaposi’s Sarcoma: Demographic and Clinical Features, Histopathology, Treatment, and Outcomes in a 10-Year Lisbon Hospital Stud. Acta Medica Portuguesa. 2025 Aug, 38(8):460-468. DOI: 10.20344/amp.17991.

3. Lopes AO, Marinho PN, Medeiros LAS, Paula VS. Oncogenes humanos do gammaherpesvírus 8 associados ao sarcoma de Kaposi. Int J Mol Sci. 2022 June, 23(13):7203. DOI: 10.3390/ijms23137203.

4. Iscovich J, Boffetta P, Franceschi S, Esther A, Sarid R. Classic Kaposi sarcoma - Epidemiology and risk factors. Int. J. Mol. Sci. 2000 Feb, 88: 500-517. DOI: 10.1002/(SICI)1097-0142(20000201)88:3<500:AID-CNCR3>3.0.CO;2-9.

5. Lazzarini R, Lopes ASA, Lellis RF, Brasil F. Iatrogenic Kaposi's sarcoma caused by corticosteroids. An Bras Dermatol. 2016 Nov-Dec, 91(6):867–869. DOI: 10.1590/abd1806-4841.20165772.