A case of cutaneous tuberculosis with two distinct types of lesions

Cutaneous tuberculosis (CTB) is a rare form of extrapulmonary manifestation of tuberculosis. The clinical spectrum of CTB depends on the site of infection, immune status of the patient, and previous sensitization with Mycobacterium tuberculosis. Simultaneous presence of two different form of CTB in an individual is uncommon. We here report a case of coexistent tuberculosis verrucosa cutis (TVC) and lupus vulgaris (LV) in a 44 year old farmer recieving anti-tumor necrosis factor-α (TNF-α) therapy. Superficial venous thrombosis of right upper extremity was also another clinical presentation in this patient and thought to be a form of tuberculids. We achived complete clinical response with anti-tuberculosis therapy. It should be kept in mind that cutaneous tuberculosis may occur more complicated than classical findings in people recieving anti-TNF-α. • Cutaneus tuberculosis have different forms • Lupus vulgaris may coexist with tuberculosis verrucosa cutis • Lupus vulgaris may spread from tuberculosis verrucosa cutis • Superficial thrombophlebitis may be a fourth form of tuberculids • Anti-TNF-α ajants may complicate the clinic presentation of cutaneus tuberculosis.