We report on a 42 year old, heterosexual black man 
presenting with an anal ulceration and generalized itch. 
Upon inspection, hyper pigmented disseminated 
cutaneous
 patches, non-removable whitish
 parallel 
plaques on the lateral borders of the tongue, and, 
moreover, residual hyper pigmentation and scarring on the 
right side of the abdomen after an episode of herpes zoster 
were observed. Based on the clinical suspicion of Kaposi 
sarcoma and oral hairy leukoplakia an advanced infection 
with HIV was suspected and, eventually, confirmed. 
This case highlights the necessity of HIV testing in 
patients suffering from various indicator diseases 
including skin diseases such as herpes zoster or seborrheic 
dermatitis. This approach may not only help to prevent 
further morbidity in affected patients and consequently 
transmission of HIV, but also proves to be cost effective.