Malakoplakia is an uncommon granulomatous lesion that afflicts predominantly immunocompromised individuals but is extremely rare in acquired immunodeficiency syndrome (AIDS). We report a case of cutaneous malakoplakia in an AIDS patient that presented as a banal right axillary abscess which resolved after excision and drainage. The rarity of malakoplakia in AIDS may be due to a relative or selective preservation of antimicrobial function of monocytes. Malakoplakia is distinguished from other inflammatory or neoplastic lesions by the presence of Michaelis-Gutmann bodies. A correct diagnosis is usually made only after biopsy and is an indication to use antimicrobial agents with adequate cellular penetration and concentration.