My first experience in the care of patients with human immunodeficiency virus (HIV) infection began in the fall of 1980 on the dermatology consult service at the Brooklyn (NY) Veterans Administration Medical Center. The patient, a young, and previously healthy, homosexual man, had developed multiple violaceous nodules with a morphology and distribution that have now become familiar. At the time, we were startled and confused by his histologic diagnosis of Kaposi's sarcoma, as were all of his doctors by his peculiar, progressive neurologic dysfunction and his death from Pneumocystis pneumonia.
Several months later, we met as a group of internists and dermatologists, seven physicians from three New York medical centers, to analyze a total of eight cases of Kaposi's sarcoma in homosexual men.1 Our report suggested that this cutaneous disease resembled one previously described in renal transplant recipients, and that an underlying immune disorder might be at work. Little