Periorbital Edema in Kaposi's Sarcoma

Bernard L. Zidar, M.D.

N Engl J Med 1995; 332:1204May 4, 1995

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Figure 1 A 27-year-old man who was seropositive for the human immunodeficiency virus presented with severe periorbital and facial edema (Panel A) and generalized cutaneous Kaposi's sarcoma. Note the lesion (arrows) on the nose. Computed tomography (CT) of the head demonstrated thickening of the eyelids and the skin of the nose and face. The patient had neither superior vena cava syndrome nor nephrotic syndrome. Doxorubicin, vincristine, and bleomycin were administered intravenously every two weeks for four months. Facial and periorbital edema resolved rapidly (Panel B), as did the Kaposi's sarcoma. The CT findings also returned to normal. This type of edema, which occurs relatively frequently in patients with the acquired immunodeficiency syndrome and Kaposi's sarcoma, can be a source of major morbidity and can compromise vision. It is a clear-cut indication for systemic chemotherapy.

Kim Eagle, M.D.

Bernard L. Zidar, M.D.
Medical College of Pennsylvania —Hahnemann University, Allegheny Campus, Pittsburgh, PA 15212

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