Careful physical examination of anyone suspected of having KS requires an evaluation of all organ systems. Physical findings relate to the site of involvement. The most common sign of the illness is the appearance of the characteristic Kaposi's sarcoma lesion . Lesions may be found in many locations, although the characteristic finding in classic KS is a single raised purple-red nodule or a cluster of lesions in a single area of the body, especially on the legs.
Physical Examination
• The skin must be carefully examined. Although the dominant lesion of classic KS is on the arms and legs, all
forms of the disease can affect any area of the skin.
• Epidemic KS may have a peculiar appearance. Typical early lesions are flat to slightly thickened, round or
slightly irregular purple spots. They are painless when they first appear and only infrequently during the
course of the disease do they cause significant pain. As the disease progresses, the lesions grow, often reaching
an inch or so in each direction. They also thicken.
• There may be different-sized spots at all stages, often growing at seemingly different rates. Many patients will
have yellow-brown pigment around the purple lesions. This bruise-like appearance is due to a small amount of
blood leaking into the tissue .
• In late stages of the disease, the plaques and nodules may grow together, occupying large areas of the skin,
blocking drainage from an extremity, causing swelling, and breaking down in areas, resulting in infection.
