Iatrogenic Penile Kaposi Sarcoma.

A 78-year-old man presented with a growing painless penile nodule one month after receiving prednisolone 60 mg daily and intravenous cyclophosphamide 500 mg for ANCA (anti-neutrophil cytoplasmic antibody) associated vasculitis. Physical examination revealed a non-tender reddish nodule measuring 3 cm in diameter on the glans (Picture 1), without any other lesions. HIV (human immunodeficiency virus) antigen and HTLV-1 (human T-lymphotropic virus type I) antibody tests were negative. A biopsy of the lesion showed the presence of spindle cells replacing dermal collagen, vascular spaces containing red blood cells, extravasated red blood cells, and hemosiderin in macrophages, thus leading to a diagnosis of Kaposi sarcoma (Picture 2). The nodule gradually shrunk over three months after tapering prednisolone to 10 mg and applying imiquimod ointment.

Picture 1.

Picture 2.

Kaposi sarcoma has five epidemiological forms; acquired immunodeficiency syndrome-related, iatrogenic, endemic, classic, and homosexual men without HIV infection. Iatrogenic Kaposi sarcoma usually develops following a solid organ allograft and it is rarely seen in non-transplant patients undergoing immunosuppressive therapy. Iatrogenic Kaposi sarcoma generally regresses after tapering immunosuppressive treatments (1,2).

The authors state that they have no Conflict of Interest (COI).