Kaposi's Sarcoma in Child. A Case Report

Gbéry Ildevert Patrice, Ecra Elidjé Joseph*, Akaffou A Evelyne, Kourouma Hamdan Sarah, Kassi Komenan, Ahogo Kouadio Celestin, Kouassi Kouamé Alexandre, Kouassi Yao Isidore, Sangaré Abdoulaye,Yoboué Yao Pauline *Department of Dermatology and Infectology, Training and Research unit of Medical Sciences, University of Felix Houphouët Boigny, Abidjan-Republique of Côte d’Ivoire Corresponding author: Ecra Elidjé Joseph, Department of Dermatology and Infectiology, Training and Research unit of Medical Sciences, University of Felix Houphouët Boigny, Abidjan-Republique of Côte d’Ivoire; Tel: 0022507840978; E-mail: joecra@hotmail.com Received date: November 13, 2015; Accepted date: December 24, 2015; Published date: January 02, 2015 Copyright: © 2015 Patrice GI. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

: Showing child affected with Kaposi's sarcoma.
An eight-year-old boy was referred to the dermatology department in Treichville Teaching Hospital for nodules and hyper-pigmented patches. The interview revealed a chicken pox eruption at 4 years old. Father was healthy, but mother died three years ago of a long lasting disease featuring high weight loss.
Initial symptoms appeared about one year earlier, marked by angiomatous patches and nodules widespread all over the body. Parents consulted a physician in a regional health center.
Medication by oral spiramycin, corticosteroids (betamethasone),antihistamines (dexchlorpheniramine) and topic bacitracin during several weeks had no effect. Considering absence of improvement and existence of widespread angiomatous patches on the trunk, the patient was referred to the dermatology department in Treichville Teaching Hospital.
The clinical check revealed • A weight at 30 kg.
• A temperature at 37°C.
• An impairment of general condition.
• Nodules and angiomatous patches of variable size disseminated all over the body predominantly on the trunk.
• Painless voluminous and firm cervical adenopathies which modified the normal aspect of the neck, as well as auxiliary and sub maxillary adenopathies

Clinical & Experimental Dermatology Research
• An edema located on the face.
• Absence of edema in the lower limbs.
Complementary tests noticed -a pathological blood cells count which revealed a microcytic anaemia with a rate of haemoglobin at 7.7g/dl, blood red cells at 3,381,030 elements/mm 3 , blood white cells at 4,000 elements/mm 3 and platelets at 431,103 elements/mm 3 .
-an intradermic tuberculin test at 00mm which demonstrated an energy to tuberculosis -Endoscopy demonstrated the existence of angiomatous nodules in the gastric mucosa.
-Normal hepatic and renal check-up.
-Absence of thoracic and lung involvement at x ray.
The diagnosis of Kaposi's sarcoma was based on the typical aspect of the lesions and histologic features: spindle cell proliferation resulting in tumour. These cells delimited vascular cavities. PERLS staining was positive.
The patient's eligibility for chemotherapy could not be assessed because of financial reasons.
Two weeks later he was lost for follow up. Three months later his death was notified to us by relatives

Discussion
Kaposi's sarcoma is uncommon in child [4]. In a study about cancers in child in Malawi, Kaposi's sarcoma was ranked in the third position with 9% of the cases far after Burkitt lymphoma, which was the commonest with 50% of cancers and retinoblastoma which accounted for 13% [5]. In another study in Zimbabwe Kaposi's sarcoma held the fourth position with 15.8% of the cases after non-Hodgkin's lymphomas, acute lymphoblastic leukaemia and Wilms' tumour [6]. The first cases described in child were ganglionic [1].
This generalized aspect of Kaposi's sarcoma in a child is found particularly associated with HIV infection. The HHSV8 is known as the causal agent of Kaposi's disease [5][6][7].
The occurrence of Kaposi's sarcoma in this child initiates HIV infection symptoms. The initial clinical context was not evocative of HIV infection since the onset of chickenpox in a child is common in Africa. The onset of Kaposi's sarcoma in an HIV infected is pejorative.
The lack of appropriate management in our patient because of low financial resources exposed him to death in a short delay. This indicates the natural story is associated to bad prognosis.

Conclusion
Though very uncommon, generalized Kaposi's sarcoma in child as we reported is a possible expression of children AIDS. The natural story is associated to bad prognosis.