Endemic African Kaposi sarcoma is a clinically and epidemiologically distinct human immunodeficiency virus negative form of Kaposi sarcoma (KS) occurring in Africa. This condition runs a variable clinical course ranging from minimal-florid cutaneous disease to extensive organ involvement. We present this seronegetive patient with peculiar and striking florid chemo-sensitive cutaneous lesions with good response in patient performance post chemotherapy. Kaposi sarcoma is chemo-sensitive and should be offered to patients as cutaneous KS lesions may be disfiguring and often generate significant psychological distress. Nigerian Medical Practitioner Vol. 50 (3&4) 2006: pp. 72-76