Laser Therapy Approaches in the Treatment of Kaposi's Sarcoma: A Comprehensive Review of Dermatologic Options.

Abstract

Introduction: Kaposi's sarcoma (KS) is a multicentric angioproliferative disease associated with human herpesvirus 8 and often exacerbated by immunosuppression. Effective treatment includes systemic and local therapies, with laser treatments gaining prominence in dermatological practice.

Objectives: This narrative review evaluated the efficacy and safety of laser treatment modalities in the management of cutaneous and mucosal KS lesions to guide dermatological decision-making.

Methods: A comprehensive English-language literature search was conducted using PubMed and Scopus up to November 2024. Search terms included "Kaposi's sarcoma", "laser therapy," and "laser treatment." Case reports and observational studies with defined patient characteristics, standardized laser protocols, and documented outcomes were included.

Results: The Nd:YAG laser emerged as the leading modality for thick, nodular KS lesions, demonstrating deep tissue penetration and high efficacy with minimal adverse effects. The pulsed dye laser (PDL) was highly effective for superficial cutaneous and mucosal lesions, with excellent cosmetic outcomes and minimal recurrence. The CO₂ laser showed promise in ablating small lesions but had limitations due to scarring risks and potential biohazard concerns. Argon lasers were historically important but are now less favored due to lower specificity for vascular targets and higher risk of non-vascular tissue damage.

Conclusions: Laser therapy offers versatile and effective treatment options for KS. Nd:YAG and PDL lasers are particularly promising due to their high efficacy, favorable safety profiles, and low recurrence rates. Further research is needed to refine laser protocols and validate long-term outcomes in different patient populations.