A 32-year-old Brazilian man infected with human immunodeficiency virus (HIV) presented with a 6-month history of a rapidly growing lesion in his lower and upper lip, associated with weight loss of 12 kg. He reported no history of trauma, tobacco smoking, heavydrinking, or any work that dealt with soil. The patient had always lived in Santarém, a city located in the Amazon region in Brazil.
Physical examination revealed an asymptomatic ulcerous vegetating lesion affecting the lower and upper gums and lips (Figure 1 and Figure 2). No regional lymphadenopathy was noticed. A skin biopsy specimen was obtained and stained with hematoxylin-eosin and periodic acid–Schiff (Figure 3).