[Facial kaposi's sarcoma. Palliative treatment with cryotherapy, intralesional chemotherapy, low-dose roentgen therapy and camouflage].

Facial Kaposi's sarcoma is a severe psychological problem for HIV-infected patients if systemic chemotherapy or interferon therapy is not possible. To help these patients, it is important to offer a palliative treatment that is suitable for outpatients and is not complicated by severe side-effects but still yield satisfactory cosmetic results. A total of 65 patients with 216 facial Kaposi's sarcomas were treated with cryosurgery (92 tumours, 29 patients), intralesional chemotherapy with vincristine (28 tumours, 12 patients), radiotherapy (87 tumours, 15 patients) and camouflage (multiple tumours, 9 patients). Cryosurgery is the treatment of choice for small (less than 1 cm) macular or slightly nodular Kaposi's sarcoma. Larger nodular tumours are better treated by intralesional chemotherapy (single doses of 0.01-0.1 mg vincristine per tumour) or low-dose radiotherapy (3-4 x 4 Gy). These palliative treatment methods are not indicated in cases of rapid tumour progression and dissemination; in such cases, camouflage (covering the tumours with water-resistant make-up) is helpful as a local palliative measure.