Une présentation cutanée inhabituelle de la maladie de Kaposi: un nodule plantaire solitaire

Kaposi's disease is a polyclonal tumor originating by chronic proliferations of Human Herpesvirus-8 (HHV-8) infected fusiform and endothelial cells. Endemic or african Kaposi's disease manifests in adults as angiomatous or pigmented nodules, macules or patches associated with bilateral lymphoedema of the legs and feet. We here report a case of epidemic Kaposi’s disease in an adult patient who presented with an unusual clinical manifestation of the disease: a solitary fleshy plantar nodule. The study involved a 68-year-old woman come to consultation in the department of dermatology with a painless plantar nodule, sometimes bleeding after trauma, which had evolved over the previous year. Physical examination showed a single rounded, angiomatous plantar nodule, measuring 3 cm along its longer axis, surrounded by a desquamative crown. The remainder of the physical examination was normal. Diagnostic hypotheses included eccrine poroma, botryomycoma and achromic melanoma. Complete excisional biopsy of the nodule was performed. Histological examination of the specimen showed tumor proliferation of fusiform cells associated with neocapillaries. This suggested Kaposi's disease. Immunostaining could not be performed as it was not available in our working environment. Our case is original because of an unusual clinical manifestation of epidemic Kaposi's disease, a solitary plantar nodule, that can be confused with botryomyoma and eccrine poroma.