Recommended surgery of Kaposi's sarcoma nodules.

BACKGROUND: Classic Kaposi's sarcoma [KS] is a chronic, multifocal, vascular proliferation, which commonly presents purplish nodules on the distal extremities of elderly men. Excisional surgery is one of the traditional therapies, but is generally time consuming and costly. OBJECTIVE: To evaluate the safety and efficacy of curettage for the treatment of KS nodules. METHODS: A single arm, prospective study in patients with at least one KS nodule removed by curettage. Hemostasis was obtained using 130-volume hydrogen peroxide [H2O2] and the wound was left to heal by secondary intention. Follow-up was done after 15 days, 1, 3, 6 and 12 months. RESULTS: Ninety patients [88 male, 2 female] with mean age of 75.8 years were enrolled. Eighty-two of the curetted nodules were localized on the lower limbs, five on the face, and three on the upper limbs. No postoperative complications were encountered, and cosmetic outcome was rated excellent by 87 patients and good by the remaining 3 patients. After 3 months, we noticed only minimal hypo-/hyperpigmentation in 59 cases, while in the remaining 31 patients the scar appeared imperceptible. Recurrence after 12 months was null. CONCLUSION: Curettage followed by the application of H2O2 is a safe, effective and simple technique for the treatment of KS nodules in elderly patients.