Atypical presentations of cutaneous tuberculosis: A case series of six patients

Abstract

Cutaneous tuberculosis (CTB), a rare extrapulmonary manifestation of Mycobacterium tuberculosis, poses a diagnostic challenge owing to its diverse clinical presentations and paucibacillary nature. We present six atypical cases diagnosed between January 2022 and January 2025 at a tertiary care centre in North India. All patients were HIV-negative, with diagnoses confirmed by histopathology, cartridge-based nucleic acid amplification test (CB-NAAT), culture, and imaging studies. Unusual manifestations included scrofuloderma of the hand overlying wrist joint TB, lupus vulgaris with acquired lymphangiectasia, tubercular gumma mimicking inoculation TB in an immunocompetent patient, scrofuloderma secondary to rib osteomyelitis, coexisting papulonecrotic tuberculid with erythema induratum of Bazin, and lupus vulgaris resembling bacillary angiomatosis. Standard anti-tubercular treatment (ATT) resulted in clinical resolution in all cases.