Kaposi sarcoma is a type of cancer that usually appears as discolored spots or lesions on your skin. Treatment depends on the type and severity of your condition.

First described in the 1870s by Dr. Moritz Kaposi, Kaposi sarcoma (KS) is characterized by dark spots that typically appear on your skin.

People who carry human herpes virus 8 (HHV-8) or human immunodeficiency virus (HIV) are most likely to develop KS lesions, as well as people from specific geographic areas and backgrounds.

This article will examine what KS lesions look and feel like as well as who gets them and how they’re treated.

Language matters

You’ll notice that the language used to share stats and other data points in this article is pretty binary, fluctuating between the use of “male” and “female” or “men” and “women.” Although we typically avoid language like this, specificity is key when reporting on research participants and findings.

Unfortunately, the studies and surveys referenced in this article did not include data on, or include, participants who were transgender, nonbinary, gender nonconforming, genderqueer, agender, or genderless.

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There are now four recognized forms of KS:

  • Classic KS: The type first described by Dr. Kaposi is now known as classic or sporadic KS. This form of the disease is most common in older men, primarily from Mediterranean, Eastern European (Ashkenazi Jewish), and South American descent. With this variety of KS, lesions usually appear on your legs. They can also affect your lymph nodes, digestive tract, or both.
  • Endemic KS: This type of KS is usually limited to people living in sub-Saharan Africa. It mostly affects Black men in the 25- to 40-year-old age range who haven’t contracted HIV. There’s a wide range of severity in this form, from barely noticeable to highly lethal. It can affect both mucosal areas (the moist, inner linings) of your skin, such as your mouth, or your internal organs.
  • Iatrogenic KS: This variety of KS appears in people who have undergone solid organ transplants or treatment with medications that can suppress your immune system. Some of the most common immune suppressant medications linked to this type of KS include cyclosporine, azathioprine, corticosteroids, and rituximab. On its own, solid organ transplants increase your risk of developing this type of KS by 500-fold. Lesions that appear with this KS type are usually limited to your skin. The lesions often fade when your immunosuppressive treatments are stopped.
  • AIDS-related or epidemic KS: This form of KS gained attention with the rise of the AIDS epidemic. HIV plays a role in the development of this type of KS. This type can affect both your skin and internal organs. Lesions can affect your skin and internal organs, and this type may also lead to other symptoms such as weight loss, fever, and diarrhea.

KS lesions usually appear on the surface of your skin. Some varieties focus on very particular areas of your body. For example, classic KS lesions usually appear on the skin of your legs — specifically on your shins.

Endemic KS can target areas of your skin that are also mucosal membranes, such as your mouth. Most forms of KS can also affect your internal organs, such as your lymph nodes or digestive tract.

The coloring of KS lesions can range from red to brown, or even purple. They can also vary in their profile, with some lesions developing flat as patches, others raised in a plaque, and some forming bumps or nodules.

This photo gallery provides images of Kaposi lesions on different skin colors.

Most forms of KS are associated with HHV-8, sometimes referred to as KS-associated herpes virus (KSHV). Globally, between 1% and 5% of people contract or carry this virus, but the numbers increase to between 10% and 20% in some Mediterranean populations and up to 80% in areas of sub-Saharan Africa.

Anyone can be affected by KS, especially people who are treated with immune-suppressing medications or who have had solid organ transplants.

People who contract or carry HHV-8 or HIV are most likely to develop KS lesions, as well as people from specific geographic areas and backgrounds. This includes people living in sub-Saharan Africa, the Mediterranean, and Eastern European men of Ashkenazi Jewish descent.

The treatment of KS depends on the specific type and severity of your condition.

If your lesions are the result of an immunosuppressant treatment, ending the treatment may help your lesions clear. But stopping or changing these treatments isn’t always an option. There’s also no guarantee that your lesions will fade.

Treatments for localized lesions

Lesions that have a limited presence on your skin’s surface only can sometimes be treated with localized therapies such as:

Treatments for systemic lesions

For people with KS that has more systemic effects or has spread to multiple areas of their body, systemic treatments are usually needed. These treatments affect your entire body, so they can be more effective if your KS is more widespread. But they also carry a risk of additional and possibly serious side effects.

Some systemic treatments used for KS include:

Specific treatment recommendations also exist for each specific form of KS.

Treatments for classic KS

There isn’t a well-defined treatment regimen for classic KS. Monitoring their condition without aggressive treatment may work for some people with noninvasive or slow-progressing KS. But single-agent chemotherapy is commonly used when more intense treatment is required.

Examples of medications that fall into this category include:

  • vinblastine
  • bleomycin
  • liposomal anthracyclines
  • taxanes

Treatments for endemic KS

Treatment for endemic KS can be similar to classic KS when your spread and severity is limited. For people with more severe KS, though, treatments can include:

Treatments for Iatrogenic KS

With this type of KS, reducing how much your immune system is suppressed is usually the preferred form of treatment. Even just changing from one medication to another may help your lesions fade or even resolve completely.

Treatments for AIDS-related KS

For many people with AIDS-related KS, antiretroviral therapy is an effective treatment. Sometimes, additional systemic treatment might be needed in combination with antiretroviral therapy.

Are Kaposi sarcoma lesions painful?

KS lesions aren’t usually painful or itchy. But when the lesions appear in areas of your body where they limit your function or block fluids, problems such as swelling or bleeding may develop.

Are Kaposi sarcoma lesions contagious?

KS lesions on their own aren’t contagious. But the herpesviruses that cause these lesions can be transmitted from one person to another through things such as saliva or sexual contact.

Do Kaposi sarcoma lesions lose color when pressed?

KS lesions can develop in a range of sizes, shapes, and colors. While the appearance may change as your condition progresses or improves, pushing on a lesion shouldn’t cause it to change color as a bruise might.

Do Kaposi sarcoma lesions go away without treatment?

Some forms of KS can get better without treatment, or rather by stopping treatments.

Medications that suppress your immune system, such as those used after solid organ transplants, are associated with a high risk of developing a form of KS. If these treatments are stopped or sometimes even changed to a different medication, it’s possible for your lesions to improve or even clear up completely.

KS is a form of skin cancer that was rarely seen before the spread of the AIDS epidemic.

AIDS and some herpesviruses can cause these lesions to form, and in some cases, the sarcoma spreads to your lymph nodes or internal organs.

Treatment may involve surgery, but more often, chemotherapy agents are used. Talk with a doctor or healthcare professional about the best treatment strategy for your specific form of KS.