A 34-year-old cisgender man with HIV returns to care after a 1-year absence from clinic; he has not been taking antiretroviral therapy for at least 10 months. His CD4 count is now 210 cells/mm³, and examination notes several purple nodular lesions on the upper arm region and chest (Figure 1). The lesions are not painful and have been slowly growing for 2 to 3 months. Biopsy confirms a spindle cell neoplasm with human herpesvirus 8 (HHV-8) positivity. He has no systemic symptoms or edema. A chest radiograph is obtained and is normal.