Our experience suggests that skin ultrasonology, particularly when performed with an extremely high frequency probes, could be important for both the diagnosis and therapy management of KS, in association with color power Doppler flow imaging, to detect the vascular activity of the cutaneous lesions [18, 19]. Over many years of ultrasound activity, we observed Ruboxistaurin clinical trial that skin lesions in patients with CKS were structurally more homogeneous and with a lower signal at the color power Doppler, compared to similar

lesions in patients with AIDS-KS, which were less homogeneous and showed more intensive signals. Based on these observations, and after having obtained the consensus of the Ethics Committee, we conducted a randomised prospective-observational study, in which we used ultrasound to evaluate the morphology and vascularisation of erythematous-papular-angiomatous skin lesions in outpatients of the MRT67307 molecular weight Infective Dermatology Division of the San Gallicano Institute, who we subsequently referred to the Radiology Department. Methods The study population consisted MM-102 concentration of patients – with final diagnosis of KS – who presented at the San Gallicano Dermatology Institute in Rome- Italy – for the first time in 2010 and who had not been previously diagnosed or undergone to any treatment. A total of 24 patients with a final

diagnosis of KS were included in the study, of whom 16 had CKS (13 males and 4 females; median age: 70 years) and 8 had AIDS-KS (all males; median age: 47 years). All patients underwent complete clinical staging. For HIV-negative patients, we used the clinical classification criteria of Brambilla [8, 13], whereas for HIV-positive patients we use a modified version of the staging of Kriegel [9] and that of Stebbing [10], based on a score from 1 to 15 (patients with a score

of > 12 generally have a worse prognosis and require systemic chemotherapy, in addition to HAART). Among patients with CKS, 14 were in stage I-II-III A/B, with non-aggressive disease and slow clinical progression. The other two CKS patients were in stage Epothilone B (EPO906, Patupilone) IV B, showing angiomatous plaques and nodules, which were prevalently localized on the lower limbs, rapidly evolving, and associated with local complications (lymphedema and bleeding). All patients with AIDS-KS belonged to the class C, with a score of >12. Histological examination of all of the lesions studied by ultrasound was performed on hematoxylin/eosin-stained tissue sections (4 μm) of biopsy samples, fixed in 10% buffered formaline and embedded in paraffin. Sections were also processed for immunohistochemical analysis of the expression of the endothelial associated antigens CD31, CD34 and podoplanin, a transmembrane mucoprotein described in a variety of lymphovascular neoplasms, including KS [20, 21] (D2-40 MoAb, Nichirei Bioscience, Tokyo, Japan) and HHV-8 LANA (anti-HHV-8 ORF73,LNA-1, Advanced Biotechnologies Inc, USA).