Symptoms

When KS lesions first appear on the skin, they are often flat patches with a pink or blood-bruise colour. They develop into nodules: hard, raised, round or oval lumps which do not go white when they are pressed, unlike bruises. Their colour is violet, bluish or reddish in light-skinned people. A bruise-like discoloration and minor swelling often appear at the edges of lesions when they are enlarging. When many nodules are present, they often appear in roughly symmetrical patterns on each side of the body and may follow the skin fold lines of the body. In some cases, the nodules can ulcerate, bleed and become infected with secondary infections.

Especially on the thighs and soles of the feet, KS lesions can form large plaques which are often swollen and painful. KS in the mouth is common, often on the roof or the gums, and may occasionally cause difficulties with chewing or swallowing.

While KS mostly commonly occurs on the skin, it can develop anywhere in the body including the lymph nodes, lungs or intestines. Prior to the introduction of highly active antiretroviral therapy (HAART), 40% of people with KS skin lesions also had lesions in their intestines. Conversely, KS can develop internally in the absence of skin lesions. In the intestines, KS is usually harmless but can sometimes cause a blockage, resulting in nausea, vomiting, abdominal pain and occasionally bleeding.

In the lymph nodes, blocked fluid drainage may cause swelling, especially in the feet, lower legs or genitals. Occasionally swelling occurs around the eyes.

KS in the lungs (pulmonary KS) is the most serious form, and can be fatal. It can lead to recurrent chest infections or accumulation of fluid on the lung (pleural effusion). There may be blood in spit, cough and breathlessness.

KS lesions sometimes occur in addition to a condition called multicentric Castleman's disease (MCD). This is a disorder of resulting from over-activity of lymph tissue. MCD is characterised by swollen lymph nodes, fever, fatigue, weight loss, night sweats, blood disorders and sometimes liver and spleen irregularities. It is thought to be caused by HHV-8 and is associated with a high prevalence of tumours and poor prognosis. MCD may develop into a type of HHV8-associated lymphoma.