{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T16:52:59Z","timestamp":1782924779464,"version":"3.54.5"},"reference-count":56,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,7,1]]},"abstract":"<jats:title>ABSTRACT.<\/jats:title>\n                  <jats:p>Kaposi sarcoma (KS) is a human herpesvirus 8 (HHV-8)\u2013associated vascular neoplasm that most commonly affects immunocompromised individuals. Endemic KS occurs in sub-Saharan Africa but rarely involves the anogenital region in pediatric patients. We report a case of a 12-year-old immunocompetent Ghanaian girl presenting with rapidly progressive nodular and fungating masses involving the trunk and external genitalia. Initial biopsies were reported as squamous papilloma; subsequent histopathologic evaluation with immunohistochemistry confirmed nodular-type KS. The patient demonstrated aggressive disease progression with lymphadenopathy and hepatomegaly, and access to systemic chemotherapy was limited because of financial constraints. Treatment with topical adapalene resulted in rapid resolution of smaller cutaneous lesions. This case highlights diagnostic challenges in resource-limited settings and supports the potential role of topical retinoids as a low-cost palliative therapy for cutaneous KS.<\/jats:p>","DOI":"10.4269\/ajtmh.24-0773","type":"journal-article","created":{"date-parts":[[2026,5,28]],"date-time":"2026-05-28T13:24:21Z","timestamp":1779974661000},"page":"162-166","source":"Crossref","is-referenced-by-count":0,"title":["Pediatric Genital Endemic Kaposi Sarcoma with Partial Response to Adapalene"],"prefix":"10.4269","volume":"115","author":[{"given":"Sanjai","family":"Nagendra","sequence":"first","affiliation":[{"name":"Labcorp, Burlington, North Carolina, USA;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anastasia","family":"Furtak","sequence":"additional","affiliation":[{"name":"Baptist Medical Centre, Nalerigu, Ghana;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edem","family":"Agamah","sequence":"additional","affiliation":[{"name":"Southern Illinois University School of Medicine, Springfield, Illinois, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Farrukh","family":"Azmi","sequence":"additional","affiliation":[{"name":"Labcorp, Burlington, North Carolina, USA;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ketan","family":"Patel","sequence":"additional","affiliation":[{"name":"Labcorp, Burlington, North Carolina, USA;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2795","reference":[{"issue":"5","key":"b1","series-title":"Diagnostics (Basel)","first-page":"1242","article-title":"Kaposi sarcoma, a trifecta of pathogenic mechanisms","volume":"12","author":"Rusu-Zota","year":"2022"},{"issue":"2","key":"b2","series-title":"Arch Dermat","first-page":"265","article-title":"Idiopathisches multiples Pigmentsarkom der Haut","volume":"4","author":"Kaposi","year":"1872"},{"issue":"9","key":"b3","series-title":"Proc R Soc Med","first-page":"866","article-title":"Kaposi\u2019s sarcoma","volume":"67","author":"Baddeley","year":"1974"},{"issue":"2","key":"b4","series-title":"Viruses","first-page":"175","article-title":"Epidemiology and genetic variability of HHV-8\/KSHV among rural populations and Kaposi\u2019s sarcoma patients in Gabon, Central Africa. Review of the geographical distribution of HHV-8 K1 genotypes in Africa","volume":"13","author":"Mamimandjiami","year":"2021"},{"issue":"4","key":"b5","series-title":"Clin Dermatol","first-page":"413","article-title":"Kaposi\u2019s sarcoma: Etiology and pathogenesis, inducing factors, causal associations, and treatments: Facts and controversies","volume":"31","author":"Ruocco","year":"2013"},{"key":"b6","series-title":"Rheumatol Curr Res","first-page":"1000144","article-title":"Stage-IV Kaposi\u2019s sarcoma during abatacept therapy: A case report","volume":"5","author":"Jalbert","year":"2015"},{"issue":"3","key":"b7","series-title":"Cancers (Basel)","first-page":"872","article-title":"Endemic Kaposi\u2019s sarcoma","volume":"15","author":"Zeinaty","year":"2023"},{"key":"b8","series-title":"Infect Agent Cancer","first-page":"33","article-title":"Endemic Kaposi sarcoma in HIV-negative children and adolescents: An evaluation of overlapping and distinct clinical features in comparison with HIV-related disease","volume":"13","author":"El-Mallawany","year":"2018"},{"issue":"1","key":"b9","series-title":"BMC Infect Dis","first-page":"1095","article-title":"Genital Kaposi sarcoma in a HIV and syphilis co-infected patient: Case presentation","volume":"19","author":"Barroso Dos Reis","year":"2019"},{"issue":"1","key":"b10","series-title":"Indian J Dermatol","first-page":"104","article-title":"Disseminated Kaposi\u2019s sarcoma with the involvement of penis in the setting of HIV infection","volume":"60","author":"Farshidpour","year":"2015"},{"issue":"12","key":"b11","series-title":"Int J Surg Case Rep","first-page":"1086","article-title":"Case report: HIV negative isolated scrotal Kaposi\u2019s sarcoma","volume":"5","author":"Ozmen","year":"2014"},{"key":"b12","series-title":"Infect Agent Cancer","first-page":"45","article-title":"Atypical presentation of classic Kaposi sarcoma in circumcised penis presenting as an ulcerative nodule with human herpesvirus 8 (HHV8) positivity and successfully treated with only local excision","volume":"14","author":"Alamri","year":"2019"},{"issue":"7","key":"b13","series-title":"Clin Case Rep","first-page":"1134","article-title":"Primary Kaposi sarcoma of the glans: A rare case in an HIV-negative patient","volume":"8","author":"Araghi","year":"2020"},{"key":"b14","series-title":"ISRN AIDS","first-page":"486425","article-title":"Anogenital lesions: Kaposi\u2019s sarcoma and its mimics","volume":"2012","author":"van Bogaert","year":"2012"},{"issue":"4","key":"b15","series-title":"South Med J","first-page":"475","article-title":"Wolf in sheep\u2019s clothing: Advanced Kaposi sarcoma mimicking vulvar abscess","volume":"98","author":"Laartz","year":"2005"},{"issue":"11","key":"b16","series-title":"S Afr Med J","first-page":"585","article-title":"Kaposi\u2019s sarcoma associated with acquired immunodeficiency syndrome presenting as a vulval papilloma. A case report","volume":"77","author":"Rajah","year":"1990"},{"issue":"2","key":"b17","series-title":"Arch Pathol Lab Med","first-page":"289","article-title":"Kaposi sarcoma","volume":"137","author":"Radu","year":"2013"},{"issue":"3","key":"b18","series-title":"Pediatr Blood Cancer","first-page":"392","article-title":"Kaposi sarcoma of childhood: Inborn or acquired immunodeficiency to oncogenic HHV-8","volume":"63","author":"Jackson","year":"2016"},{"issue":"4","key":"b19","series-title":"Cancer Metastasis Rev","first-page":"749","article-title":"Navigating the heterogeneous landscape of pediatric Kaposi sarcoma","volume":"38","author":"Kamiyango","year":"2019"},{"issue":"1","key":"b20","series-title":"Nat Rev Dis Primers","first-page":"9","article-title":"Kaposi sarcoma","volume":"5","author":"Cesarman","year":"2019"},{"issue":"9","key":"b21","series-title":"Pharmaceuticals (Basel)","first-page":"217","article-title":"Recent advances regarding the therapeutic potential of adapalene","volume":"13","author":"Rusu","year":"2020"},{"issue":"20","key":"b22","series-title":"Int J Mol Sci","first-page":"12622","article-title":"The use of retinoids for the prevention and treatment of skin cancers: An updated review","volume":"23","author":"Ramchatesingh","year":"2022"},{"issue":"7","key":"b23","series-title":"Mol Cell Biol","first-page":"4159","article-title":"Retinoid antagonism of NF-IL6: Insight into the mechanism of antiproliferative effects of retinoids in Kaposi\u2019s sarcoma","volume":"17","author":"Nagpal","year":"1997"},{"issue":"5","key":"b24","series-title":"J Clin Invest","first-page":"1981","article-title":"Antiproliferative effect of retinoid compounds on Kaposi\u2019s sarcoma cells","volume":"93","author":"Corbeil","year":"1994"},{"issue":"12","key":"b25","series-title":"Clin Case Rep","first-page":"3340","article-title":"Involution of classic Kaposi sarcoma lesions under acitretin treatment Kaposi sarcoma treated with acitretin","volume":"8","author":"Daadaa","year":"2020"},{"issue":"12","key":"b26","series-title":"Arch Dermatol","first-page":"1461","article-title":"Topical treatment of cutaneous lesions of acquired immunodeficiency syndrome-related Kaposi sarcoma using alitretinoin gel: Results of phase 1 and 2 trials","volume":"136","author":"Duvic","year":"2000"},{"issue":"1","key":"b27","series-title":"Actas Dermosifiliogr","first-page":"50","article-title":"Sarcoma de Kaposi cl\u00e1sico tratado con alitretino\u00edna t\u00f3pica","volume":"98","author":"Gonz\u00e1lez de Arriba","year":"2007"},{"issue":"12","key":"b28","series-title":"Cancer","first-page":"2555","article-title":"A multicenter phase II study of the intravenous administration of liposomal tretinoin in patients with acquired immunodeficiency syndrome-associated Kaposi\u2019s sarcoma","volume":"95","author":"Bernstein","year":"2002"},{"issue":"5","key":"b1","series-title":"Diagnostics (Basel)","first-page":"1242","article-title":"Kaposi sarcoma, a trifecta of pathogenic mechanisms","volume":"12","author":"Rusu-Zota","year":"2022"},{"issue":"2","key":"b2","series-title":"Arch Dermat","first-page":"265","article-title":"Idiopathisches multiples Pigmentsarkom der Haut","volume":"4","author":"Kaposi","year":"1872"},{"issue":"9","key":"b3","series-title":"Proc R Soc Med","first-page":"866","article-title":"Kaposi\u2019s sarcoma","volume":"67","author":"Baddeley","year":"1974"},{"issue":"2","key":"b4","series-title":"Viruses","first-page":"175","article-title":"Epidemiology and genetic variability of HHV-8\/KSHV among rural populations and Kaposi\u2019s sarcoma patients in Gabon, Central Africa. Review of the geographical distribution of HHV-8 K1 genotypes in Africa","volume":"13","author":"Mamimandjiami","year":"2021"},{"issue":"4","key":"b5","series-title":"Clin Dermatol","first-page":"413","article-title":"Kaposi\u2019s sarcoma: Etiology and pathogenesis, inducing factors, causal associations, and treatments: Facts and controversies","volume":"31","author":"Ruocco","year":"2013"},{"key":"b6","series-title":"Rheumatol Curr Res","first-page":"1000144","article-title":"Stage-IV Kaposi\u2019s sarcoma during abatacept therapy: A case report","volume":"5","author":"Jalbert","year":"2015"},{"issue":"3","key":"b7","series-title":"Cancers (Basel)","first-page":"872","article-title":"Endemic Kaposi\u2019s sarcoma","volume":"15","author":"Zeinaty","year":"2023"},{"key":"b8","series-title":"Infect Agent Cancer","first-page":"33","article-title":"Endemic Kaposi sarcoma in HIV-negative children and adolescents: An evaluation of overlapping and distinct clinical features in comparison with HIV-related disease","volume":"13","author":"El-Mallawany","year":"2018"},{"issue":"1","key":"b9","series-title":"BMC Infect Dis","first-page":"1095","article-title":"Genital Kaposi sarcoma in a HIV and syphilis co-infected patient: Case presentation","volume":"19","author":"Barroso Dos Reis","year":"2019"},{"issue":"1","key":"b10","series-title":"Indian J Dermatol","first-page":"104","article-title":"Disseminated Kaposi\u2019s sarcoma with the involvement of penis in the setting of HIV infection","volume":"60","author":"Farshidpour","year":"2015"},{"issue":"12","key":"b11","series-title":"Int J Surg Case Rep","first-page":"1086","article-title":"Case report: HIV negative isolated scrotal Kaposi\u2019s sarcoma","volume":"5","author":"Ozmen","year":"2014"},{"key":"b12","series-title":"Infect Agent Cancer","first-page":"45","article-title":"Atypical presentation of classic Kaposi sarcoma in circumcised penis presenting as an ulcerative nodule with human herpesvirus 8 (HHV8) positivity and successfully treated with only local excision","volume":"14","author":"Alamri","year":"2019"},{"issue":"7","key":"b13","series-title":"Clin Case Rep","first-page":"1134","article-title":"Primary Kaposi sarcoma of the glans: A rare case in an HIV-negative patient","volume":"8","author":"Araghi","year":"2020"},{"key":"b14","series-title":"ISRN AIDS","first-page":"486425","article-title":"Anogenital lesions: Kaposi\u2019s sarcoma and its mimics","volume":"2012","author":"van Bogaert","year":"2012"},{"issue":"4","key":"b15","series-title":"South Med J","first-page":"475","article-title":"Wolf in sheep\u2019s clothing: Advanced Kaposi sarcoma mimicking vulvar abscess","volume":"98","author":"Laartz","year":"2005"},{"issue":"11","key":"b16","series-title":"S Afr Med J","first-page":"585","article-title":"Kaposi\u2019s sarcoma associated with acquired immunodeficiency syndrome presenting as a vulval papilloma. 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