Kaposi sarcoma lesions: Pictures and more

Finding a strange purple or reddish spot on your skin is enough to make anyone pause mid-shower.
Most of the time, these spots are harmless bruises, veins, or rashes. But sometimes, especially
in people with weakened immune systems, they can be something more serious, such as Kaposi sarcoma
lesions. This guide walks you through what Kaposi sarcoma is, what its lesions usually look like,
how doctors use pictures and exams to tell it apart from other conditions, and why getting a
professional opinion matters much more than scrolling through scary images online.

This article is for general education only and is not a substitute for seeing a healthcare
professional. If you notice new or changing spots, especially if you have a weakened immune system,
talk with your doctor promptly.

What is Kaposi sarcoma?

Kaposi sarcoma is a type of cancer that develops from the cells lining blood vessels and lymph
vessels. Instead of forming one solid lump, it often shows up as multiple lesions on the skin or
mucous membranes (like the inside of the mouth), and it can also affect internal organs such as
the digestive tract and lungs.

All forms of Kaposi sarcoma are linked to infection with a virus called human herpesvirus 8 (HHV-8).
Many people carry HHV-8 without ever knowing it, but the virus tends to cause problems when the
immune system is significantly weakened. That is why Kaposi sarcoma is best known in people living
with HIV or AIDS, organ transplant recipients taking strong immune-suppressing drugs, and others
with serious immune compromise.

Main types of Kaposi sarcoma

• Classic Kaposi sarcoma: Usually affects older adults, often men of Mediterranean,
  Eastern European, or Middle Eastern descent. Lesions tend to appear slowly, often on the lower legs
  and feet, and may remain limited for years.
• Endemic (African) Kaposi sarcoma: Seen in some parts of sub-Saharan Africa, where
  HHV-8 infection is more common. It can affect children and adults and may be more aggressive.
• Iatrogenic (transplant-related) Kaposi sarcoma: Occurs in people who take
  immune-suppressing medications to prevent organ rejection, such as after kidney or liver transplant.
• AIDS-related Kaposi sarcoma: Develops in people with untreated or advanced HIV.
  It may spread quickly and can involve skin, mouth, lymph nodes, and internal organs.

Clinically, all of these types share the same basic building blocks: blood-vessel-derived tumor cells,
excess blood flow, and inflammatory cells that create the characteristic bruise-like look of Kaposi
sarcoma lesions.

What do Kaposi sarcoma lesions look like?

If you look at Kaposi sarcoma pictures from dermatology texts or cancer centers, you will notice that
the lesions have a fairly distinctive palette and pattern. However, they do not all look identical,
and photos can be misleading. Here are the common features doctors look for.

Color and appearance

• Color: Lesions are often pink, red, purple, or brown. On lighter skin tones, they
  may look like tiny wine-colored dots or bruises. On darker skin tones, they can appear dark purple,
  maroon, or nearly black.
• Shape: They may start as flat spots (macules or patches) and can thicken into
  slightly raised plaques or more dome-shaped nodules over time.
• Texture: The surface is usually smooth, although thicker plaques or nodules can
  become rough, ulcerated, or crusted if they are irritated or injured.
• Sensation: Many lesions are painless. Some people notice mild tenderness, itching,
  or swelling nearby, especially if the lesions are clustered or involve the legs.

In medical image galleries, you will often see close-up photos of small, round, purple to red spots on
the feet and legs, clusters of dark lesions on the face, or reddish-purple plaques on the trunk or arms.
Oral lesions may look like dark red or purple patches on the gums, palate (roof of the mouth), or inner
cheeks.

Common locations for Kaposi sarcoma lesions

• Lower legs, ankles, and feet
• Face (especially the nose and around the mouth)
• Hands and arms
• Inside the mouth (gums, palate)
• Genital and anal areas

In some people, swelling (edema) of the legs or genital area can occur along with the skin lesions.
This may be due to tumor growth blocking lymph or blood flow.

Lesions you cannot see: internal Kaposi sarcoma

Not all Kaposi sarcoma lesions show up where you can see them in the mirror. Some form in the
digestive tract or lungs. These may cause:

• Unexplained stomach pain or cramping
• Blood in the stool or black, tarry stools
• Coughing up blood or shortness of breath
• Unintentional weight loss, fatigue, or persistent fevers

Internal lesions are usually detected with endoscopy, imaging tests, and biopsy, not just by looking
at the skin.

Kaposi sarcoma pictures: what they show (and what they do not)

Online, the phrase “Kaposi sarcoma lesions pictures” pulls up pages of highly magnified, sometimes
dramatic images. These can be useful for doctors and medical students, but for patients, they can
be both confusing and frightening.

It is important to remember:

• Pictures emphasize clear cases: Medical photos often show classic, textbook lesions.
  Real-world cases can look subtler, especially early on.
• Skin tone matters: The same lesion can look very different on light versus dark skin.
  Many older image collections under-represent darker skin tones.
• Many conditions mimic Kaposi sarcoma: Benign vascular lesions, bruises, eczema,
  psoriasis, or pigmented spots can resemble Kaposi sarcoma in photos.
• Pictures cannot confirm or rule out cancer: A correct diagnosis depends on a
  physical exam and usually a biopsy, not image-matching on your phone.

If you are concerned about a spot that resembles something you have seen in Kaposi sarcoma images,
use the picture as a prompt to see a healthcare professional, not as a final verdict.

How doctors diagnose Kaposi sarcoma lesions

When someone presents with suspicious lesions, especially in the setting of HIV, prior transplant,
or another cause of immune suppression, doctors follow a stepwise approach.

Clinical exam

First, a clinician takes a detailed history, including immune status, medications, prior infections,
and any systemic symptoms such as weight loss or shortness of breath. Then they examine:

• All skin surfaces (not just the one lesion that prompted the visit)
• Inside the mouth and sometimes the nose or throat
• Any swollen lymph nodes

They look at the color, shape, distribution, and progression of the lesions to decide whether they
fit the pattern of Kaposi sarcoma or another condition.

Biopsy and lab testing

To confirm the diagnosis, a small sample of the lesion is removed (biopsied) under local anesthesia.
A pathologist examines the tissue under a microscope. Classic Kaposi sarcoma shows:

• Spindle-shaped tumor cells forming slit-like spaces
• Red blood cells leaking into the tissue
• Markers that indicate HHV-8 infection on special stains

Blood tests and imaging may also be ordered to assess immune status and check for involvement of
internal organs.

Treatment options and how lesions can change

Treatment for Kaposi sarcoma depends on the type, how extensive the lesions are, the person’s overall
health, and how well their immune system is functioning. The main goals are to control tumor growth,
manage symptoms, and improve both survival and quality of life.

Improving immune function

In AIDS-related Kaposi sarcoma, starting or optimizing antiretroviral therapy can make a huge
difference. As the immune system recovers, lesions may shrink, fade, or stop appearing. In some
people, antiretroviral therapy alone leads to major improvement.

Local treatments for visible lesions

For a small number of bothersome lesions, doctors may use:

• Minor surgery to remove individual lesions
• Cryotherapy (freezing with liquid nitrogen)
• Laser therapy or local radiation for cosmetically sensitive sites
• Topical medications in selected cases

After treatment, lesions may flatten and fade over time, leaving behind faint discoloration or a
small scar.

Systemic therapies

If lesions are widespread, progressing quickly, or affecting internal organs, systemic treatment may
be recommended. Options can include chemotherapy drugs, targeted agents in clinical trials, or
newer immunotherapies. These treatments aim to slow or reverse tumor growth throughout the body,
not just at one spot.

When to see a doctor about possible Kaposi sarcoma lesions

Not every purple spot is cancer, but some situations deserve prompt medical attention. You should
seek care quickly if:

• You live with HIV or another cause of immune suppression and notice new red, purple, or brown spots.
• Existing lesions are increasing in number, size, or thickness.
• You have unexplained swelling in your legs, groin, or genital area.
• You experience symptoms like coughing up blood, persistent shortness of breath, black or bloody stools, or unexplained weight loss.

Early evaluation can help distinguish Kaposi sarcoma from other conditions, start appropriate
treatment sooner, and prevent complications.

Living with Kaposi sarcoma lesions

Beyond the biology of the disease, Kaposi sarcoma lesions can take a real emotional and social toll.
They are often visible, sometimes on the face or hands, and can feel like an unwanted announcement
of illness to everyone around you.

People may worry about stigma related to HIV, cancer, or both. It is common to feel self-conscious,
anxious, or even angry about how the lesions look. Supportive counseling, patient support groups,
and honest conversations with trusted friends or family can help.

Practical tips that some patients find helpful include:

• Using clothing or makeup strategically to cover visible lesions, if desired.
• Planning medical appointments ahead of emotionally charged events (such as weddings or job interviews), when possible.
• Asking the care team for photos or diagrams that show expected treatment results.
• Connecting with others who have navigated similar diagnoses through support groups or online communities hosted by reputable organizations.

Experiences related to Kaposi sarcoma lesions

While every person’s story is unique, shared experiences can make an unfamiliar diagnosis feel a
little less overwhelming. The following composite scenarios are based on common clinical patterns
and patient reports; they do not describe any one specific individual.

Case 1: The “mysterious bruise” that was not a bruise
Alex, a man in his late 30s living with untreated HIV, noticed what looked like a stubborn bruise on
his ankle. It did not hurt, but it also did not fade like a normal bruise. A few months later, he
spotted two similar purple patches on his other leg. When he finally searched online, he landed on
Kaposi sarcoma pictures and felt a jolt of fear. Part of him wanted to slam the laptop shut and ignore
it. Instead, he booked an appointment at an HIV clinic. The clinician examined all of his skin,
checked inside his mouth, ordered some blood work, and performed a small skin biopsy. Within days,
the diagnosis of Kaposi sarcoma was confirmed, and he started combination antiretroviral therapy
along with close oncology follow-up. Over the next year, his immune system strengthened, and the
lesions flattened and faded, becoming more like faint shadows than bright purple warnings.

Case 2: After a kidney transplant
Maria received a kidney transplant in her 50s. A few years later, she noticed reddish-brown spots
on her feet and lower legs. She assumed they were related to poor circulation or sun damage, until
her transplant team took a look and raised the possibility of Kaposi sarcoma. A biopsy confirmed the
diagnosis. Her doctors carefully adjusted her immune-suppressing medications to give her immune
system a bit more room to work while still protecting the transplanted kidney. They also treated
a few of the most prominent lesions with local therapy so she would feel more comfortable wearing
skirts and sandals again. For Maria, regular check-ins, clear explanations, and knowing what to expect
from future images and exams helped reduce the anxiety she felt every time she spotted a new freckle.

Case 3: Internal lesions first
In some people, internal Kaposi sarcoma shows itself before skin lesions do. Imagine someone who
begins having unexplained abdominal pain and black stools. After endoscopy, the gastroenterologist
sees reddish-purple bumps in the lining of the stomach and small intestine. Biopsies reveal Kaposi
sarcoma. Only later, when the patient and doctor look more closely, do they notice a few subtle
purple spots on the legs that had been written off as “just discoloration.” This kind of story
illustrates why doctors do a head-to-toe skin and mucosal exam once the diagnosis is on the table.

Emotional side: seeing yourself in the pictures
Many people describe the moment they first recognize themselves in an online image as a turning point.
For some, it feels like validation: “I knew something was wrong.” For others, it is a shock: “I did not
think my spots looked that serious until I saw them next to those photos.” A useful way to reframe this
is to treat pictures as a starting point, not the final word. They can prompt questions: How similar are
my lesions really? What else could it be? What tests will clarify things? These questions are best
answered in the exam room, not in a late-night browser tab.

Working with your care team
People who feel empowered to participate in decisions about their care tend to do better emotionally,
and sometimes physically, as well. Bringing printed pictures or screenshots to an appointment can
actually be helpfulyour doctor can point out where your lesions match or differ from the images and
explain why they are leaning toward one diagnosis instead of another. Over time, serial photographs
of your own lesions (taken with your phone under similar lighting) can serve as a visual record of how
treatment is working.

Key takeaways

Kaposi sarcoma lesions are cancerous growths arising from blood and lymph vessel lining, often appearing
as purple, red, or brown spots or nodules on the skin or in the mouth, and sometimes in internal organs.
They are linked to HHV-8 infection and are more common when the immune system is weakened. While online
pictures can give a basic idea of what these lesions look like, they cannot replace a professional exam
and biopsy. If you have a weakened immune system or other risk factors and notice new, persistent, or
changing lesions, the most important step is not to memorize every image you find online, but to make an
appointment with a qualified healthcare provider.