Efficacy and safety of the combination therapy of CO ₂ laser and thalidomide in cutaneous classic Kaposi’s sarcoma

This study evaluates the efficacy and safety of a combined treatment approach using CO2 laser therapy and oral Thalidomide for the management of skin lesions in patients with classic Kaposi's sarcoma (CKS). We conducted a prospective observational study at the First Affiliated Hospital of Guangxi Medical University, spanning from April 2021 to April 2023. The study focused on assessing the therapeutic outcomes in terms of macroscopic and microscopic changes in skin lesions before and after the treatment. This study enrolled 10 patients with an average age of 62.8 years, who predominantly exhibited skin lesions on their lower limbs, with some involvement of the upper limbs. Throughout the 6-24 months follow-up period, patients were administered oral thalidomide at a dosage of 100 mg per day and underwent three CO2 laser sessions on average. Post-treatment, complete resolution of Kaposi's sarcoma (KS) was observed in 9 out of 10 patients, with histopathology and dermoscopy showing no residual KS-related manifestations. Adverse reactions occurred in three patients (30%), including red marks, skin scars, and itching. The combination of CO2 laser therapy with oral thalidomide offers a straightforward, efficacious, and safe treatment for cutaneous lesions in classic CKS patients.