Nodular Classic Kaposi's Sarcoma Treated With Neodymium-Doped Yttrium Aluminum Garnet Laser Delivered Through a Tilted Angle: Outcome and 12-Month Follow Up.

Classic Kaposi's sarcoma (KS) is a multifocal angioproliferative disorder with a long and indolent course typically affecting the lower extremities of elderly men. Multiple nodules with a rapid growth may sometimes develop, causing pain, bleeding, and discomfort on walking. In such cases, immediate intervention using different methods, including laser therapy, is advisable. We report our experience in classic KS patients with the use of neodymium-doped yttrium aluminum garnet (Nd:YAG) laser delivered through a tilted angle.

A total of 81 KS nodules (0.5-3 cm size) located in the feet or lower limbs of nine patients (mean age: 78.8 years; age range: 64-86 years) were selected for treatment with Nd:YAG laser (5-7 mm spot, 140-200 J/cm² fluence, 5 ms triple pulse with 10 ms delay). The laser beam was delivered at the periphery of each nodule using a tilted angle of 30° to 60° according to lesion size in order to better target the feeding vessels located in the inner and basal depth of the lesion and minimize tissue damage. The treatment outcome was evaluated by clinical photograph, videodermatoscopy, and ultrasound scanning performed before and after treatment, and at each monthly follow-up visit.

All treated patients showed full recovery, with negligible scarring, no residual hyperpigmentation, and complete regression of pain. Treatment discomfort was minimal and use of topical anesthetics was not needed. No recurrences were observed at 12-month follow up.Long-pulse Nd:YAG laser delivered using a tilted angle is a fast, easy, effective, comfortable, and safe treatment option available to promptly shrink bulky, painful, or bleeding nodules with minimal discomfort and gives excellent functional and cosmetic results. Lasers Surg. Med. © 2020 Wiley Periodicals, Inc.