BMJ 2005;330:1063 (7 May), doi:10.1136/bmj.330.7499.1063
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The bad news and the bad news
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I recently saw a 64 year old man with a skin lesion on his knee that had been intermittently weeping pus over the past four weeks and had been growing in size. The lesion was well demarcated, granulomatous, and about 2x2 cm in size. He had had it for over a year, but it had never bothered him until recently. The lesion did not look infected, so I decided to remove it and send it for histology.
Four days later, I was called by a consultant pathologist, who started quizzing me about this patient. Specifically he wanted to know the patient's sexual orientation and whether he was an intravenous drug user. The patient was homosexual, and when I told the consultant so it seemed to confirm his suspicion. "This looks like a nodular Kaposi's sarcoma," he said, "but I will need to send it to an expert in
Mark Taubert, GP registrar
Ty Bryn Surgery, Caerphilly (mtaubert@hotmail.com)
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