Kaposi's sarcoma: A new approach of lesional follow-up using epiluminescent light microscopy

The diagnostic accuracy of in vivo epiluminescent light microscopy (ELM) in vascular skin lesions such as Kaposi's sarcoma (KS) is low, due to the lac k of specific diagnostic features. This highly reproducible technique could however be useful in the follow-up of KS lesions since the AIDS Clinical T rial Group's (ACTG) criteria are mainly based on macroscopy. The aim of thi s study was to assess the suitability of ELM in KS as a tool for follow-up of lesions during local and systemic treatments. 42 AIDS-related KS lesions from 20 patients were prospectively evaluated clinically and using ELM dur ing local and systemic therapies. Evolution of KS lesions documented by ELM correlated with the evolution of clinical ACTG criteria. Changes in ELM fe atures gave in many cases a more precise idea of therapeutic response than macroscopic analysis alone. ELM constitutes a safe and reproducible techniq ue to follow up KS lesions.