On Examination The multiple pigmented macules, erythematous plaques that were blue-purple, small- and medium-sized purple nodules and some dense bullae were in her lower leg regions and on the foot dorsum. The case was clinically diagnosed as the classical type of KS with bullae formation. Skin biopsy revealed a subepidermal bulla (splitting) overlying lymphedema associated with an underlying KS tumor nodule with spindle cell proliferation in the reticular dermis. Laboratory data revealed high IL-6 serum levels and anti-HHV8 IgG antibodies. Immunohistochemistry showed CD34 and human herpes virus 8 (HHV8) in the skin.
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