Kaposi’s sarcoma on the sole

This lesion looks quite worrying. It arose over three months but had not bled. The dermatoscopy image (inset) is also of concern, showing  pigmentation at the top in a parallel ridge pattern. This dermatoscopic pattern is very suggestive of acral melanoma but it could be thrombosed blood under the stratum corneum. This was a Kaposi’s sarcoma, a vascular tumour caused by herpes 8 virus, commonly seen in patients with AIDS. This patient was not HIV positive. He exhibited the old-fashioned variant seen in elderly, often Jewish, males from the Mediterranean region. These lesions can be excised if small or treated with radiotherapy.