Laser Therapy Approaches in the Treatment of Kaposi’s Sarcoma: A Comprehensive Review of Dermatologic Options
Keywords:
Kaposi's sarcoma, Laser therapy, Pulsed dye laser, PDL, Nd:YAG laserAbstract
Introduction: Kaposi sarcoma 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 evaluates 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. Pulsed dye laser 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.
References
Denis, D., Seta, V., Regnier-Rosencher, E., Kramkimel, N., Chanal, J., Avril, M. F., & Dupin, N. (2018). A fifth subtype of Kaposi's sarcoma, classic Kaposi's sarcoma in men who have sex with men: a cohort study in Paris. Journal of the European Academy of Dermatology and Venereology : JEADV, 32(8), 1377–1384. https://doi.org/10.1111/jdv.14831
Marcoval, J., Bonfill-Ortí, M., Martínez-Molina, L., Valentí-Medina, F., Penín, R. M., & Servitje, O. (2019). Evolution of Kaposi sarcoma in the past 30 years in a tertiary hospital of the European Mediterranean basin. Clinical and experimental dermatology, 44(1), 32–39. https://doi.org/10.1111/ced.13605
Dal Maso, L., Polesel, J., Ascoli, V., Zambon, P., Budroni, M., Ferretti, S., Tumino, R., Tagliabue, G., Patriarca, S., Federico, M., Vercelli, M., Giacomin, A., Vicario, G., Bellù, F., Falcini, F., Crocetti, E., De Lisi, V., Vitarelli, S., Piffer, S., Stracci, F., … Cancer and AIDS Registry Linkage Study (2005). Classic Kaposi's sarcoma in Italy, 1985-1998. British journal of cancer, 92(1), 188–193. https://doi.org/10.1038/sj.bjc.6602265
Stratigos, J. D., Potouridou, I., Katoulis, A. C., Hatziolou, E., Christofidou, E., Stratigos, A., Hatzakis, A., & Stavrianeas, N. G. (1997). Classic Kaposi's sarcoma in Greece: a clinico-epidemiological profile. International journal of dermatology, 36(10), 735–740. https://doi.org/10.1046/j.1365-4362.1997.00284.x
Lodi, S., Guiguet, M., Costagliola, D., Fisher, M., de Luca, A., Porter, K., & CASCADE Collaboration (2010). Kaposi sarcoma incidence and survival among HIV-infected homosexual men after HIV seroconversion. Journal of the National Cancer Institute, 102(11), 784–792. https://doi.org/10.1093/jnci/djq134
Maurer, T., Ponte, M., & Leslie, K. (2007). HIV-associated Kaposi's sarcoma with a high CD4 count and a low viral load. The New England journal of medicine, 357(13), 1352–1353. https://doi.org/10.1056/NEJMc070508
Poizot-Martin, I., Brégigeon, S., Palich, R., Marcelin, A. G., Valantin, M. A., Solas, C., Veyri, M., Spano, J. P., & Makinson, A. (2022). Immune Reconstitution Inflammatory Syndrome Associated Kaposi Sarcoma. Cancers, 14(4), 986. https://doi.org/10.3390/cancers14040986
Euvrard, S., Kanitakis, J., & Claudy, A. (2003). Skin cancers after organ transplantation. The New England journal of medicine, 348(17), 1681–1691. https://doi.org/10.1056/NEJMra022137
Moosa M. R. (2005). Kaposi's sarcoma in kidney transplant recipients: a 23-year experience. QJM : monthly journal of the Association of Physicians, 98(3), 205–214. https://doi.org/10.1093/qjmed/hci028
Krown, S. E., Metroka, C., & Wernz, J. C. (1989). Kaposi's sarcoma in the acquired immune deficiency syndrome: a proposal for uniform evaluation, response, and staging criteria. AIDS Clinical Trials Group Oncology Committee. Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 7(9), 1201–1207. https://doi.org/10.1200/JCO.1989.7.9.1201
Lebbe, C., Garbe, C., Stratigos, A. J., Harwood, C., Peris, K., Marmol, V. D., Malvehy, J., Zalaudek, I., Hoeller, C., Dummer, R., Forsea, A. M., Kandolf-Sekulovic, L., Olah, J., Arenberger, P., Bylaite-Bucinskiene, M., Vieira, R., Middleton, M., Levy, A., Eggermont, A. M., Battistella, M., … European Dermatology Forum (EDF), the European Association of Dermato-Oncology (EADO) and the European Organisation for Research and Treatment of Cancer (EORTC) (2019). Diagnosis and treatment of Kaposi's sarcoma: European consensus-based interdisciplinary guideline (EDF/EADO/EORTC). European journal of cancer (Oxford, England : 1990), 114, 117–127. https://doi.org/10.1016/j.ejca.2018.12.036
Di Lorenzo, G., Kreuter, A., Di Trolio, R., Guarini, A., Romano, C., Montesarchio, V., Brockmeyer, N. H., De Placido, S., Bower, M., & Dezube, B. J. (2008). Activity and safety of pegylated liposomal doxorubicin as first-line therapy in the treatment of non-visceral classic Kaposi's sarcoma: a multicenter study. The Journal of investigative dermatology, 128(6), 1578–1580. https://doi.org/10.1038/sj.jid.5701215
Tulpule, A., Groopman, J., Saville, M. W., Harrington, W., Jr, Friedman-Kien, A., Espina, B. M., Garces, C., Mantelle, L., Mettinger, K., Scadden, D. T., & Gill, P. S. (2002). Multicenter trial of low-dose paclitaxel in patients with advanced AIDS-related Kaposi sarcoma. Cancer, 95(1), 147–154. https://doi.org/10.1002/cncr.10634
Paksoy, N., Khanmammadov, N., Doğan, İ., Ferhatoğlu, F., Ahmed, M. A., Karaman, S., & Aydiner, A. (2023). Weekly paclitaxel treatment in the first-line therapy of classic Kaposi sarcoma: A real-life study. Medicine, 102(5), e32866. https://doi.org/10.1097/MD.0000000000032866
Brambilla, L., Labianca, R., Boneschi, V., Fossati, S., Dallavalle, G., Finzi, A. F., & Luporini, G. (1994). Mediterranean Kaposi's sarcoma in the elderly. A randomized study of oral etoposide versus vinblastine. Cancer, 74(10), 2873–2878. https://doi.org/10.1002/1097-0142(19941115)74:10<2873::aid-cncr2820741021>3.0.co;2-1
Tur, E., & Brenner, S. (1998). Classic Kaposi's sarcoma: low-dose interferon alfa treatment. Dermatology (Basel, Switzerland), 197(1), 37–42. https://doi.org/10.1159/000017973
Saller, J., Walko, C. M., Millis, S. Z., Henderson-Jackson, E., Makanji, R., & Brohl, A. S. (2018). Response to Checkpoint Inhibitor Therapy in Advanced Classic Kaposi Sarcoma: A Case Report and Immunogenomic Study. Journal of the National Comprehensive Cancer Network : JNCCN, 16(7), 797–800. https://doi.org/10.6004/jnccn.2018.7018
Galanina, N., Goodman, A. M., Cohen, P. R., Frampton, G. M., & Kurzrock, R. (2018). Successful Treatment of HIV-Associated Kaposi Sarcoma with Immune Checkpoint Blockade. Cancer immunology research, 6(10), 1129–1135. https://doi.org/10.1158/2326-6066.CIR-18-0121
Nguyen, H. Q., Magaret, A. S., Kitahata, M. M., Van Rompaey, S. E., Wald, A., & Casper, C. (2008). Persistent Kaposi sarcoma in the era of highly active antiretroviral therapy: characterizing the predictors of clinical response. AIDS (London, England), 22(8), 937–945. https://doi.org/10.1097/QAD.0b013e3282ff6275
Saiag, P., Brunet, H., & Fortier-Beaulieu, M. (1995). Les traitements locaux dans la maladie de Kaposi associée au SIDA [Local treatments of AIDS-related Kaposi disease]. Annales de dermatologie et de venereologie, 122(8), 551–557.
Caccialanza, M., Marca, S., Piccinno, R., & Eulisse, G. (2008). Radiotherapy of classic and human immunodeficiency virus-related Kaposi's sarcoma: results in 1482 lesions. Journal of the European Academy of Dermatology and Venereology : JEADV, 22(3), 297–302. https://doi.org/10.1111/j.1468-3083.2007.02405.x
Boudreaux, A. A., Smith, L. L., Cosby, C. D., Bason, M. M., Tappero, J. W., & Berger, T. G. (1993). Intralesional vinblastine for cutaneous Kaposi's sarcoma associated with acquired immunodeficiency syndrome. A clinical trial to evaluate efficacy and discomfort associated with infection. Journal of the American Academy of Dermatology, 28(1), 61–65. https://doi.org/10.1016/0190-9622(93)70010-q
Brambilla, L., Bellinvia, M., Tourlaki, A., Scoppio, B., Gaiani, F., & Boneschi, V. (2010). Intralesional vincristine as first-line therapy for nodular lesions in classic Kaposi sarcoma: a prospective study in 151 patients. The British journal of dermatology, 162(4), 854–859. https://doi.org/10.1111/j.1365-2133.2009.09601.x
Di Monta, G., Caracò, C., Benedetto, L., La Padula, S., Marone, U., Tornesello, M. L., Buonaguro, F. M., Simeone, E., Ascierto, P. A., & Mozzillo, N. (2014). Electrochemotherapy as "new standard of care" treatment for cutaneous Kaposi's sarcoma. European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology, 40(1), 61–66. https://doi.org/10.1016/j.ejso.2013.09.002
Ferioli M, Galuppi A, Buwenge M, Cammelli S, Perrone AM, Macchia G, Deodato F, Cilla S, Zamagni A, De Terlizzi F, Tagliaferri L, De Iaco P, Morganti AG. Electrochemotherapy in Kaposi sarcoma: A systematic review. Mol Clin Oncol. 2021 Apr;14(4):64. doi: 10.3892/mco.2021.2226. Epub 2021 Feb 8. PMID: 33680455; PMCID: PMC7890459.
Célestin Schartz, N. E., Chevret, S., Paz, C., Kerob, D., Verola, O., Morel, P., & Lebbé, C. (2008). Imiquimod 5% cream for treatment of HIV-negative Kaposi's sarcoma skin lesions: A phase I to II, open-label trial in 17 patients. Journal of the American Academy of Dermatology, 58(4), 585–591. https://doi.org/10.1016/j.jaad.2007.11.005
Bodsworth, N. J., Bloch, M., Bower, M., Donnell, D., Yocum, R., & International Panretin Gel KS Study Group (2001). Phase III vehicle-controlled, multi-centered study of topical alitretinoin gel 0.1% in cutaneous AIDS-related Kaposi's sarcoma. American journal of clinical dermatology, 2(2), 77–87. https://doi.org/10.2165/00128071-200102020-00004
Tappero, J. W., Berger, T. G., Kaplan, L. D., Volberding, P. A., & Kahn, J. O. (1991). Cryotherapy for cutaneous Kaposi's sarcoma (KS) associated with acquired immune deficiency syndrome (AIDS): a phase II trial. Journal of acquired immune deficiency syndromes, 4(9), 839–846.
Chun, Y. S., Chang, S. N., & Park, W. H. (1999). A case of classical Kaposi's sarcoma of the penis showing a good response to high-energy pulsed carbon dioxide laser therapy. The Journal of dermatology, 26(4), 240–243. https://doi.org/10.1111/j.1346-8138.1999.tb03464.x
Baggish, M. S., Poiesz, B. J., Joret, D., Williamson, P., & Refai, A. (1991). Presence of human immunodeficiency virus DNA in laser smoke. Lasers in surgery and medicine, 11(3), 197–203. https://doi.org/10.1002/lsm.1900110302
Wheeland, R. G., Bailin, P. L., & Norris, M. J. (1985). Argon laser photocoagulative therapy of Kaposi's sarcoma: a clinical and histologic evaluation. The Journal of dermatologic surgery and oncology, 11(12), 1180–1185. https://doi.org/10.1111/j.1524-4725.1985.tb03092.x
Wheeland R. G. (1995). Clinical uses of lasers in dermatology. Lasers in surgery and medicine, 16(1), 2–23. https://doi.org/10.1002/lsm.1900160103
Tappero, J. W., Grekin, R. C., Zanelli, G. A., & Berger, T. G. (1992). Pulsed-dye laser therapy for cutaneous Kaposi's sarcoma associated with acquired immunodeficiency syndrome. Journal of the American Academy of Dermatology, 27(4), 526–530. https://doi.org/10.1016/0190-9622(92)70217-4
Marchell, N., & Alster, T. S. (1997). Successful treatment of cutaneous Kaposi's sarcoma by the 585-nm pulsed dye laser. Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.], 23(10), 973–975. https://doi.org/10.1111/j.1524-4725.1997.tb00762.x
Bassi, A., Bonan, P., Cannarozzo, G., Bruscino, N., Dindelli, M., Lorenzoni, E., & Campolmi, P. (2011). New successful treatment of genital AIDS-related Kaposi's sarcoma resistant to systemic therapy with 595-nm pulsed dye laser. Giornale italiano di dermatologia e venereologia : organo ufficiale, Societa italiana di dermatologia e sifilografia, 146(6), 507–508.
Junejo, M. H., Hibler, B. P., Levin, L., Menzer, C., Aleisa, A., & Rossi, A. M. (2024). Non-ablative Laser Therapy for Cutaneous Kaposi Sarcoma - A Single Center Proof-of-Concept Study of Six Patients. Clinical and experimental dermatology, llae390. Advance online publication. https://doi.org/10.1093/ced/llae390
Spicer, M. S., & Goldberg, D. J. (1996). Lasers in dermatology. Journal of the American Academy of Dermatology, 34(1), 1–28. https://doi.org/10.1016/s0190-9622(96)90827-0
Landthaler, M., & Hohenleutner, U. (2006). Laser therapy of vascular lesions. Photodermatology, photoimmunology & photomedicine, 22(6), 324–332. https://doi.org/10.1111/j.1600-0781.2006.00254.x
Özdemir, M., & Balevi, A. (2017). Successful Treatment of Classic Kaposi Sarcoma With Long-Pulse Neodymium-Doped Yttrium Aluminum Garnet Laser: A Preliminary Study. Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.], 43(3), 366–370. https://doi.org/10.1097/DSS.0000000000000973
Nasca, M. R., Luppino, I., Spurio Catena, A., & Micali, G. (2020). Nodular Classic Kaposi's Sarcoma Treated With Neodymium-Doped Yttrium Aluminum Garnet Laser Delivered Through a Tilted Angle: Outcome and 12-Month Follow Up. Lasers in surgery and medicine, 52(10), 979–983. https://doi.org/10.1002/lsm.23242
Silvestri, M., Latini, A., Lesnoni La Parola, I., Messina, C., Nisticò, S. P., & Cameli, N. (2022). Effectiveness and Safety of Treatment with Neodymium:YAG Laser 1064 nm in Patients with Classic and Epidemic Kaposi Sarcoma. Bioengineering (Basel, Switzerland), 9(3), 106. https://doi.org/10.3390/bioengineering9030106
Bostanci, S., Aygun Alizada, M., Farabi, B., & Akay, B. N. (2024). Efficacy of Long-Pulsed Nd:YAG Laser for Classic Kaposi's Sarcoma: A Dermoscopic Study. Dermatology practical & conceptual, 14(2), e2024150. https://doi.org/10.5826/dpc.1402a150
Srinivas, C. R., & Kumaresan, M. (2011). Lasers for vascular lesions: standard guidelines of care. Indian journal of dermatology, venereology and leprology, 77(3), 349–368. https://doi.org/10.4103/0378-6323.79728
Martinez, V., Caumes, E., Gambotti, L., Ittah, H., Morini, J. P., Deleuze, J., Gorin, I., Katlama, C., Bricaire, F., & Dupin, N. (2006). Remission from Kaposi's sarcoma on HAART is associated with suppression of HIV replication and is independent of protease inhibitor therapy. British journal of cancer, 94(7), 1000–1006. https://doi.org/10.1038/sj.bjc.6603056
Downloads
Published
Issue
Section
License
Copyright (c) 2025 Chiara Battilotti, Fortunato Cassalia, Francesca Svara, Alessandra Latini, Norma Cameli, Steven Paul Nisticò

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Dermatology Practical & Conceptual applies a Creative Commons Attribution License (CCAL) to all works we publish (http://creativecommons.org/licenses/by-nc/4.0/). Authors retain the copyright for their published work.