A 42-year-old African American man with human immunodeficiency virus infection was admitted for evaluation of gastrointestinal symptoms. He had not seen his primary physician for 3 years and had discontinued his antiviral therapy because he was discouraged about his medical condition. Ten years earlier, a cutaneous eruption had developed on his legs. The lesions, which had multiplied and slowly evolved over the past decade, had suddenly proliferated over the prior 6 months, forming a sizable mass on his right leg. He had noticed increased malodorous drainage from the growths for a few weeks but had not sought evaluation or treatment. His CD4 cell count at this admission was 248/μL (reference range, 976-1357/μL), and his viral load was 5.6 copies/mL.