A 71-year-old-female with HIV since 2005, presented to us in the clinic with a lesion on the dorsal aspect of her right wrist, which she had for the past 3years. Her latest CD4 count in November was 225cells/mL with undetectable viral load. She was on abacavir, lamivudine and ritonavir-boosted atazanavir. The lesion was non-tender with normal overlying skin and it was non-mobile. It measured at about 1cm in width. However, 6months later, the lesion had significantly changed with a new lesion seen lateral to the initial lesion.