Sporotrichoid Violaceous Plaques on the Arm: Challenge

Lymphangioma-like Kaposi sarcoma (LLKS) is a rare histologic variant of Kaposi sarcoma that can closely mimic benign vascular proliferations, posing a diagnostic challenge—especially in immunocompetent individuals. We report a case of LLKS in an HIV-negative elderly man who presented with unilateral, sporotrichoid violaceous papules and plaques confined to the upper limb. Histopathologic examination demonstrated irregularly dilated vascular channels with positive immunostaining for human herpesvirus 8 (HHV-8). This case underscores the importance of considering LLKS in the differential diagnosis of vascular-appearing lesions in immunocompetent patients with atypical clinical presentations.