A 61-year-old African American male with human immunodeficiency virus (HIV) infection diagnosed in 2003 and acquired immunodeficiency syndrome (AIDS) (CD4 of 171 cells/mm3 and viral load of 187 copies/mm3) with a history of poor adherence to ART presented to the Veterans Affairs Dermatology clinic with ulcerated plaques on his buttocks and a tender fungating mass with milky drainage located posterior to his scrotum for three months (Figure 1). The gene discussed is CD4; the disease is AIDS.