Abstract: An 87-year-old male patient who presented with erythema, papules and scaling on the extremities accompanied by severe pruritus for more than one year.HIV was negative, and the initially diagnosed with atopic dermatitis. Conventional treatment only yielded recurrent symptoms. Re-examined histopathology and positive immunohistochemical markers (HHV8, CD34, CD31) confirmed classic Kaposi's sarcoma. The lesion presented eczematous features at initial visit. Atypical early pathological changes and improper biopsy site led to misdiagnosis of Kaposi's sarcoma.This case suggests that clinicians should be alert to neoplastic diseases when encountering elderly patients with intractable and progressive eczematous skin lesions.

Key words: classical Kaposi's sarcoma, atopic dermatitis, misdiagnosis, elderly patients