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red spot on big toe - kaposi sarcoma?
Mar 2, 2001

I apologize for the lengthy nature of this question - please bear with me. My husband has a red spot on his big toe, between the toenail and the joint in the toe, which, for lack of a better descriptive term, looks like a hickey. It is not painful. He says he has had this for a couple of months now, but was not concerned about it until last night, when he noticed two very small spots, similar in color, on other toes. He is very concerned that these could be kaposi sarcoma. We have been in a monogamous relationship for close to seven years. I have never had any other sex partners. My husband had multiple sex partners before me. He once tested false positive for HIV, approximately 3 months after his last contact with anyone else. He retested about 3 months after the false positive (6 months after contact with anyone else), and the results were negative. When I became pregnant, about 2 years after his last contact with any other partners, I was tested for HIV as a routine part of the pregnancy, and my results were negative. Is it possible to take such a long time for HIV to show up? It doesn't seem to me that it is, but that one false positive is scaring my husband to death. He had blood drawn today for an HIV test, but he's in the military, and it often takes a long time for us to get test results. And the doctor here at our base clinic can't see him to look at his foot for another week. Are there other skin conditions which can cause long term skin discoloration of this kind? I've read that Kaposi Sarcoma is related to herpes. My husband is very susceptible to cold sores and I believe he had shingles once as a child. Could this be a non-HIV related Kaposi Sarcoma? I guess I'm just looking for some answers until he gets his test results. Thank you.

Response from Dr. Dezube

Unfortunately there's really no way for me to tell over the internet whether this is Kaposi's sarcoma (KS) or not. There are many many other lesions this could be other than KS. Basically any lesion which does not heal should be biopsied. This is the only real way to know. KS is clearly much more common in HIV-infected individuals. You do bring up an interesting question -- could this be a non-HIV related KS? This type of KS is less common in the US, than the HIV-related variety. Also HIV-negative KS tends to be much less aggressive than the HIV-positive variety. You need concrete answers. The blood test for HIV will help. He may eventually need a punch biopsy of one of his skin lesions; this is a relatively minor procedure. Good luck.


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