Nonepidemic Kaposi sarcoma: A recently proposed category

HHV-8: human herpesvirus-8 KS: Kaposi sarcoma MSM: men who have sex with men INTRODUCTION Kaposi sarcoma (KS) is an indolent angioproliferative tumor thought to be dependent on viral replication, immune modulation, and inflammatory cytokines produced by infected endothelial and immune cells. Human herpesvirus-8 (HHV-8) is thought to cause KS and is documented in more than 95% of patients with KS. The skin is the most common site of presentation, although visceral disease, most commonly affecting the lungs and the gastrointestinal tract, may also occur. KS typically manifests as violaceous, dark brownorblackmacules, papules, and nodules on the lower extremities that are prone to bleeding and ulceration. It has a slow-growing course in immunocompetent individuals. We present the unusual case of a HIV-negative yet high-risk man in whom cutaneous KS lesions developed on the face that exhibited a complete response to topical imiquimod and tretinoin. Our patient represents an additional case of the rare, underrecognized category knownasnonepidemicKS.