Use of vincristine for the intralesional treatment of cutaneous Kaposi disease lesions: experience on 10 patients

Kaposi’s Sarcoma is a tumor of endothelial cells caused by a viral infection (HHV-8). It, in its classical form (cKS), is particularly common in the Mediterranean area. It manifests with red-violet nodules and plaques located especially in the lower limbs. Among the topical therapies the intralesional use of vincristine, although off-label, can be used for the nodular limited forms. Our study includes ten patients, HIV negative, suffering from the classical form of Kaposi’s Sarcoma. 35 nodules were recruited and two categories were identified: Small (diameter less than 0.8 cm) and Large (diameter greater than 0.8 cm) for which either 0,05 mL and 0.1 mL of vincristine were injected respectively. The therapy was carried out following a 42-day cycle, at the end of which the progress of the nodules was evaluated according to the ACTG criteria. In total of the 35 nodules: 23 (65.71%) were resolved at the end of treatment, 12 (34.28%) were persistent even with a reduction in diameter. In no case has an increase in the nodular diameter been noted. We therefore believe that the intralesional use of vincristine can be considered at the first line of the treatment of Kaposian nodules, qualifying as more effective and safer than other local treatments.