Acta Derm Venereol 87 435Letters to the Editor

Paclitaxel (PTX) has been shown to be efficacious with minimal toxicity in patients with AIDS-associated Kaposi’s sarcoma (KS) and transplantation-associated KS. Recently, a few cases of non-AIDS-associated KS treated with PTX have been reported. We report here a patient with classical KS who showed a dramatic response to weekly PTX therapy. Complete remission was maintained for 8 months. After lesions recurred, the same PTX regimen was resumed, resulting in a renewed remission. CASE REPORT A 52-year-old Japanese man had been treated for clas-sical KS since the age of 32 years. Despite several excision and radiotherapy treatments (totally 65 Gy for each lesion), the disease progressed to multiple tumours on his extremities. Physical examination in Novem-ber 2003, before initiation of PTX treatment, showed multiple violaceous to dark-red patches, plaques, and nodules of varying sizes on a background of severely oedematous skin on his legs, arms, buttocks, hands and soles (Fig. 1A). Histological examination showed mul-tiple small slit-like vascular proliferations in the dermis and spindle cell proliferation around these vessels (Fig. 2A, B). The spindle cells were CD34-positive. Human herpesvirus 8 DNA sequences were detected from skin tumour by PCR technique. Human immunodeficiency virus (HIV) antibody was negative in serum. There was no evidence of systemic involvement of KS. Weekly, intravenous treatments with PTX (TAXOL®, Bristol-Myers Squibb Company, Mayaguez, Puerto Rico) 80 mg/m2/week, for 3 consecutive weeks, every 4 weeks were then initiated. After 4 treatment courses, the KS dramatically improved with an almost complete disap-pearance of all skin lesions and pain due to oedema of the legs. The response was maintained for 8 months, whereafter the lesions recurred. The same regimen of PTX was immediately resumed for 2 further courses, again resulting in almost complete remission (Fig