Chronic perianal ulcerations over the buttocks in an adult: an insidious manifestation of cutaneous tuberculosis

Cutaneous tuberculosis (TB) is a chronic granulomatous infection, constituting 1.5-3% of extrapulmonary cases. Disease manifestation is a result of the intricate interplay between host immunity, bacterial virulence and route of inoculation. Orificial TB, a relatively rare manifestation of cutaneous TB, accounts for 2.7% of the cases. We report a case of orificial TB of the perianal region in a man with underlying pulmonary miliary TB. This case highlights the importance of holistic evaluation, strong clinical suspicion and timely investigations, which can lead to swift resolution of lesions.