{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,6]],"date-time":"2025-11-06T16:19:49Z","timestamp":1762445989999,"version":"build-2065373602"},"reference-count":31,"publisher":"Mattioli1885","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:p>Introduction: Kaposi sarcoma (KS) is a low grade angio-proliferative tumor of endothelial origin. Human herpes virus 8 (HHV8) plays a major role in the pathogenesis of KS. Classic Kaposi sarcoma is commonly seen among elderly of Mediterranean origin. It is usually slowly progressive and is rarely fatal. There is no definitive cure for KS. Beta blockers were used with great success in the treatment of infantile hemangioma. Because of some similarity between infantile hemangioma and Kaposi sarcoma, topical beta blockers were tried with variable success rate. Objectives: We aimed to assess the efficacy and safety of oral propranolol in the treatment of classic Kaposi sarcoma. Methods: Fifteen patients diagnosed with classic Kaposi sarcoma were prospectively enrolled in the study. Detailed history and full clinical examination were conducted. Histopathological diagnosis with confirmatory immune staining was done for all patients. Oral propranolol in a dose of 60 mg was given per day for 6 months. The patients assessed clinically as complete responders, partial responders, and non-responders. Results: Nine patients (60%) were partial responders; showed 50% reduction in the number of the existing lesions, and 6 patients (40%) were considered non-responders; 3 with stable disease and 3 with progressive disease. Lymphedema partially improved in 1 patient. Conclusions: Oral propranolol is a safe and good option for treatment of patients with non-complicated classic Kaposi sarcoma, especially elderly with multiple comorbidities.<\/jats:p>","DOI":"10.5826\/dpc.1501a4737","type":"journal-article","created":{"date-parts":[[2025,1,29]],"date-time":"2025-01-29T12:43:50Z","timestamp":1738154630000},"page":"4737","source":"Crossref","is-referenced-by-count":0,"title":["Propranolol: A Promising Therapeutic Avenue for Classic Kaposi Sarcoma"],"prefix":"10.5826","volume":"15","author":[{"given":"Rasha Mahmoud","family":"Genedy","sequence":"first","affiliation":[{"name":"Dermatology, venereology, and andrology department, Faculty of medicine, Alexandria university, Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marwa","family":"Owais","sequence":"additional","affiliation":[{"name":"Dermatology, venereology, and andrology department, Faculty of medicine, Alexandria university, Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Naglaa Mohamed","family":"El Sayed","sequence":"additional","affiliation":[{"name":"Dermatology, venereology, and andrology department, faculty of medicine, Alexandria university,Egypt department , Faculty of medicine, Alexandria university, Egyptlexandria unive"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"27750","published-online":{"date-parts":[[2025,1,29]]},"reference":[{"key":"10.5826\/dpc.1501a4737_ref1","doi-asserted-by":"crossref","unstructured":"Ruocco E, Ruocco V, Tornesello ML, Gambardella A, Wolf R, Buonaguro FM. Kaposi's sarcoma: etiology and pathogenesis, inducing factors, causal associations, and treatments: facts and controversies. Clin Dermatol. 2013;31(4):413-422. DOI: 10.1016\/j.clindermatol.2013.01.008. PMID: 23806158. PMCID: PMC7173141.","DOI":"10.1016\/j.clindermatol.2013.01.008"},{"key":"10.5826\/dpc.1501a4737_ref2","doi-asserted-by":"crossref","unstructured":"Schwartz RA, Micali G, Nasca MR, Scuderi L. Kaposi sarcoma: A continuing conundrum. J Am Acad Dermatol. 2008;59(2):179-206. DOI:10.1016\/j.jaad.2008.05.001. PMID: 18638627.","DOI":"10.1016\/j.jaad.2008.05.001"},{"key":"10.5826\/dpc.1501a4737_ref3","doi-asserted-by":"crossref","unstructured":"Liu Z, Fang Q, Zuo J, Minhas V, Wood C, Zhang T. The world\u2010wide incidence of Kaposi's sarcoma in the HIV\/AIDS era. HIV medicine. 2018 May;19(5):355-364. DOI: 10.1111\/hiv.12584","DOI":"10.1111\/hiv.12584"},{"key":"10.5826\/dpc.1501a4737_ref4","doi-asserted-by":"crossref","unstructured":"P\u00fcttgen K, Lucky A, Adams D, et al. Topical timolol maleate treatment of infantile hemangiomas. Pediatrics. 2016; 138 (3): e20160355 DOI: 10.1542\/peds.2016-0355","DOI":"10.1542\/peds.2016-0355"},{"key":"10.5826\/dpc.1501a4737_ref5","doi-asserted-by":"crossref","unstructured":"L\u00e9aut\u00e9-Labr\u00e8ze C, Hoeger P, Mazereeuw-Hautier J, et al. A randomized, controlled trial of oral propranolol in infantile hemangioma. N Engl J Med. 2015; 372 (8):735-746 DOI: 10.1056\/NEJMoa1404710","DOI":"10.1056\/NEJMoa1404710"},{"key":"10.5826\/dpc.1501a4737_ref6","doi-asserted-by":"crossref","unstructured":"Storch CH, Hoeger PH. Propranolol for infantile haemangiomas: insights into the molecular mechanisms of action. Br J Dermatol 2010; 163 (2): 269\u2013274 DOI: 10.1111\/j.1365-2133.2010.09848.","DOI":"10.1111\/j.1365-2133.2010.09848.x"},{"key":"10.5826\/dpc.1501a4737_ref7","doi-asserted-by":"crossref","unstructured":"Cuesta AM, Gallardo-Vara E, Casado-Vela J, Recio-Poveda L, Botella LM, Albi\u00f1ana V. The Role of Propranolol as a Repurposed Drug in Rare Vascular Diseases. Int J Mol sci. 2022; 23 (8): 4217. DOI: 10.3390\/ijms23084217","DOI":"10.3390\/ijms23084217"},{"key":"10.5826\/dpc.1501a4737_ref8","doi-asserted-by":"crossref","unstructured":"Chisholm KM, Chang KW, Truong MT, Kwok S, West RB, Heerema-McKenney AE. \u03b2-adrenergic receptor expression in vascular tumors. Mod Pathol. 2012;25 (11):1446-1451. DOI:10.1038\/modpathol.2012.108","DOI":"10.1038\/modpathol.2012.108"},{"key":"10.5826\/dpc.1501a4737_ref9","doi-asserted-by":"crossref","unstructured":"Meseguer-Yebra C, Cardenoso-Alvarez ME, Bordel-Gomez MT, Fraile-Alonso MC, Perez-Losada ME, Sanchez-Estella J: Successful treatment of classic Kaposi sarcoma with topical timolol: report of two cases. Br J Dermatol. 2015;173 (3):860-862. DOI: 10.1111\/bjd.13746","DOI":"10.1111\/bjd.13746"},{"key":"10.5826\/dpc.1501a4737_ref10","doi-asserted-by":"crossref","unstructured":"Alcantara-Reifs CM, Salido-Vallejo R, Garnacho-Saucedo GM, Velez Garcia-Nieto A: Classic Kaposi's sarcoma treated with topical 0.5% timolol gel. Dermatol Ther. 2016; 29:309-311.","DOI":"10.1111\/dth.12381"},{"key":"10.5826\/dpc.1501a4737_ref11","doi-asserted-by":"crossref","unstructured":"Cmr G, Licata G, Briatico G, et al. Comparison between propranolol 2% cream versus timolol 0.5% gel for the treatment of Kaposi sarcoma. Int J Dermatol. 2021; 60: 631\u2013633. DOI: 10.1111\/ijd.15407","DOI":"10.1111\/ijd.15407"},{"key":"10.5826\/dpc.1501a4737_ref12","doi-asserted-by":"crossref","unstructured":"Sharquie KE, Noaimi AA. Treatment of Kaposi\u2019s Sarcoma by Combination of Zinc Sulfate and Propranolol. Journal of Cosmetics, Dermatological Sciences and Applications. 2018; 8 (4):249-255. DOI: 10.4236\/jcdsa.2018.84026.","DOI":"10.4236\/jcdsa.2018.84026"},{"key":"10.5826\/dpc.1501a4737_ref13","doi-asserted-by":"crossref","unstructured":"Salido-Vallejo R, Gonz\u00e1lez-Menchen A, Alc\u00e1ntara-Reifs C, Espa\u00f1a A. Treatment with Oral Propranolol for Refractory Classic Cutaneous Kaposi Sarcoma. JAMA dermatology. 2022; 11 (7): 832-834. DOI:10.1001\/jamadermatol.2022.1278","DOI":"10.1001\/jamadermatol.2022.1278"},{"key":"10.5826\/dpc.1501a4737_ref14","doi-asserted-by":"crossref","unstructured":"Mine T, Koike Y, Ehara D, Murota H. A case of bilateral plantar pseudo-Kaposi sarcoma successfully treated with propranolol. JAAD Case Reports. 2021; 18:74-78. DOI: 10.1016\/j.jdcr.2021.09.032","DOI":"10.1016\/j.jdcr.2021.09.032"},{"key":"10.5826\/dpc.1501a4737_ref15","doi-asserted-by":"crossref","unstructured":"Horst C, Kapur N. Propranolol: a novel treatment for angiolymphoid hyperplasia with eosinophilia. Clin Exp Dermatol. 2014; 39 (7): 810-812. DOI:10.1111\/ced.12412","DOI":"10.1111\/ced.12412"},{"key":"10.5826\/dpc.1501a4737_ref16","doi-asserted-by":"crossref","unstructured":"Krown SE, Metroka C, Wernz JC. Kaposi sarcoma in the acquired immune deficiency syndrome: a proposal for uniform evaluation, response, and staging criteria. AIDS Clinical Trials Group oncology committee. J Clin Oncol. 1989; 7 (9):1201\u20131207","DOI":"10.1200\/JCO.1989.7.9.1201"},{"key":"10.5826\/dpc.1501a4737_ref17","doi-asserted-by":"crossref","unstructured":"Ramaswami R, Polizzotto MN, Lurain K, et al. Safety, activity, and long-term outcomes of pomalidomide in the treatment of Kaposi sarcoma among individuals with or without HIV infection. Clinical Cancer Research. 2022; 28 (5): 840-850. DOI: 10.1158\/1078-0432.CCR-21-3364","DOI":"10.1158\/1078-0432.CCR-21-3364"},{"key":"10.5826\/dpc.1501a4737_ref18","doi-asserted-by":"crossref","unstructured":"Paksoy N, Khanmammadov N, Do\u011fan \u0130, ,et al. Weekly paclitaxel treatment in the first-line therapy of classic Kaposi sarcoma: A real-life study. Medicine. 2023; 102 (5):e32866. DOI: 10.1097\/MD.0000000000032866","DOI":"10.1097\/MD.0000000000032866"},{"key":"10.5826\/dpc.1501a4737_ref19","unstructured":"Brambilla L, Boneschi V, Taglioni M, Ferrucci S. Staging of classic Kaposi\u2019s sarcoma: a useful tool for therapeutic choices. Euro J Dermatol. 2003; 28 (1):83-86."},{"key":"10.5826\/dpc.1501a4737_ref20","doi-asserted-by":"crossref","unstructured":"Greene AK, Goss JA. Diagnosis and staging of lymphedema. Semin Plast Surg 2018; 32 (1): 012-016. DOI: 10.1055\/s-0038-1635117","DOI":"10.1055\/s-0038-1635117"},{"key":"10.5826\/dpc.1501a4737_ref21","doi-asserted-by":"crossref","unstructured":"Benajiba L, Lambert J, La Selva R, et al. Systemic Treatment Initiation in Classical and Endemic Kaposi\u2019s Sarcoma: Risk Factors and Global Multi-State Modelling in a Monocentric Cohort Study. Cancers. 2021; 13 (11):2519. DOI: 10.3390\/cancers13112519","DOI":"10.3390\/cancers13112519"},{"key":"10.5826\/dpc.1501a4737_ref22","doi-asserted-by":"crossref","unstructured":"R\u00e9gnier-Rosencher E, Guillot B, Dupin N. Treatments for classic Kaposi sarcoma: a systematic review of the literature. J Am Acad Dermatol. 2013; 68 (2):313-331. DOI:10.1016\/j.jaad.2012.04.018","DOI":"10.1016\/j.jaad.2012.04.018"},{"key":"10.5826\/dpc.1501a4737_ref23","doi-asserted-by":"crossref","unstructured":"Lamy S, Lachambre MP, Lord-Dufour S, B\u00e9liveau R. Propranolol suppresses angiogenesis in vitro: inhibition of proliferation, migration, and differentiation of endothelial cells. Vascul pharmacol. 2010; 53 (5-6):200-208. DOI:10.1016\/j.vph.2010.08.002","DOI":"10.1016\/j.vph.2010.08.002"},{"key":"10.5826\/dpc.1501a4737_ref24","doi-asserted-by":"crossref","unstructured":"Stiles JM, Amaya C, Rains S, et al. Targeting of beta-adrenergic receptors results in therapeutic efficacy against models of hemangioendothelioma and angiosarcoma. PloS one. 2013;8 (3): e60021. DOI: 10.1371\/journal.pone.0060021","DOI":"10.1371\/journal.pone.0060021"},{"key":"10.5826\/dpc.1501a4737_ref25","doi-asserted-by":"crossref","unstructured":"Gramolelli S, Schulz TF. The role of Kaposi sarcoma\u2010associated herpesvirus in the pathogenesis of Kaposi sarcoma. J pathol. 2015; 235 (2):368-380. DOI: 10.1002\/path.4441","DOI":"10.1002\/path.4441"},{"key":"10.5826\/dpc.1501a4737_ref26","doi-asserted-by":"crossref","unstructured":"Chang M, Brown HJ, Collado-Hidalgo A, et al. \u03b2-Adrenoreceptors reactivate Kaposi's sarcoma-associated herpesvirus lytic replication via PKA-dependent control of viral RTA. J virol. 2005; 79 (21):13538-13547. DOI:10.1128\/JVI.79.21.13538\u201313547.2005","DOI":"10.1128\/JVI.79.21.13538-13547.2005"},{"key":"10.5826\/dpc.1501a4737_ref27","doi-asserted-by":"crossref","unstructured":"McAllister SC, Hanson RS, Manion RD. Propranolol decreases proliferation of endothelial cells transformed by Kaposi's sarcoma-associated herpesvirus and induces lytic viral gene expression. J virol. 2015; 89 (21):11144-11149. DOI: 10.1128\/jvi.01569-15","DOI":"10.1128\/JVI.01569-15"},{"key":"10.5826\/dpc.1501a4737_ref28","doi-asserted-by":"crossref","unstructured":"Amaya CN, Perkins M, Belmont A, et al. Non-selective beta blockers inhibit angiosarcoma cell viability and increase progression free-and overall-survival in patients diagnosed with metastatic angiosarcoma. Oncoscience. 2018; 5 (3-4):109-119. DOI: 10.18632\/oncoscience.413","DOI":"10.18632\/oncoscience.413"},{"key":"10.5826\/dpc.1501a4737_ref29","doi-asserted-by":"crossref","unstructured":"Santos M, Vilasboas V, Mendes L, Talhari C, Talhari S. Lymphangiectatic Kaposi's sarcoma in a patient with AIDS. An Bras Dermatol. 2013; 88 (2):276-278. DOI 10.1590\/S0365-05962013000200019","DOI":"10.1590\/S0365-05962013000200019"},{"key":"10.5826\/dpc.1501a4737_ref30","doi-asserted-by":"crossref","unstructured":"Brambilla L, Tourlaki A, Ferrucci S, Brambati M, Boneschi V. Treatment of classic Kaposi's sarcoma\u2010associated lymphedema with elastic stockings. J dermatol. 2006; 33 (7):451-456. DOI: 10.1111\/j.1346-8138.2006.00108.x","DOI":"10.1111\/j.1346-8138.2006.00108.x"},{"key":"10.5826\/dpc.1501a4737_ref31","doi-asserted-by":"crossref","unstructured":"Montero P\u00e9rez I, Rodr\u00edguez\u2010Pazos L, \u00c1lvarez\u2010P\u00e9rez A, et al. Kaposi sarcoma following postmastectomy lymphedema. J Cut Pathol. 2015; 42 (11):889-893. DOI: 10.1111\/cup. 12573","DOI":"10.1111\/cup.12573"}],"container-title":["Dermatology Practical &amp; Conceptual"],"original-title":[],"link":[{"URL":"https:\/\/dpcj.org\/index.php\/dpc\/article\/download\/4737\/3034","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/dpcj.org\/index.php\/dpc\/article\/download\/4737\/3446","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/dpcj.org\/index.php\/dpc\/article\/download\/4737\/3034","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,6]],"date-time":"2025-11-06T16:15:41Z","timestamp":1762445741000},"score":1,"resource":{"primary":{"URL":"https:\/\/dpcj.org\/index.php\/dpc\/article\/view\/4737"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,1,29]]},"references-count":31,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025]]}},"URL":"https:\/\/doi.org\/10.5826\/dpc.1501a4737","relation":{"has-manifestation":[{"id-type":"other","id":"1-78-4737-g3034","asserted-by":"subject"},{"id-type":"other","id":"1-78-4737-g3446","asserted-by":"subject"}],"is-part-of":[{"id-type":"doi","id":"10.5826\/dpc.v15i1","asserted-by":"subject"}]},"ISSN":["2160-9381"],"issn-type":[{"type":"electronic","value":"2160-9381"}],"subject":[],"published":{"date-parts":[[2025,1,29]]},"article-number":"10"}}