Epidemiologic and clinical types of Kaposi sarcoma

Type	Predominant risk groups	Cutaneous presentation	Visceral involvement	Clinical course
Classic (sporadic)	Approximately 3:1 male:female ratio Age >60 Mediterranean or Central/Eastern European origin; Middle East	Distal lower extremities	Uncommon	Usually indolent; rarely aggressive and disseminated
Endemic (African)	Male adults Children of both sexes Equatorial Africa	Various (may be similar to classic or more locally aggressive); lower extremity lymphedema in adults; cutaneous disease often absent in children	Internal organs involved in a subset of adult patients Common (lymph nodes and viscera) in children	Indolent to locally invasive in adults Occasional rapid progression with visceral disease in adults Aggressive in children
Iatrogenic (immunosuppression related)	Exogenous immunosuppression, especially solid organ transplant Older patients (>50) Use of cyclosporin A	Distal lower extremities; may be disseminated	Relatively common	May regress with modification of immunosuppression May be aggressive
AIDS associated	Men who have sex with men (resource-abundant countries) Heterosexual males and females (Africa)	Localized or disseminated	Common with poor HIV control	Aggressive or indolent May regress with effective HIV treatment

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