Cutaneous tuberculosis with features suggestive of scrofuloderma masquerading as hidradenitis suppurativa: a case report

Scrofuloderma is a form of cutaneous tuberculosis that results from the spread of infection from an underlying focus, most commonly lymph nodes or bone, to the overlying skin. It shares overlapping features with various other cutaneous diseases, such as hidradenitis suppurativa. We report a 47-year-old woman presenting with a 4-year history of anterior chest swelling and a 2-year history of a right axillary mass that had ruptured spontaneously. The patient had undergone multiple incisions and drainage procedures and received several courses of antibiotics with limited success. Diagnostic investigations including imaging, biopsy, and ultrasound-guided cartridge-based nucleic acid amplification test supported a diagnosis of cutaneous tuberculosis with features suggestive of scrofuloderma involving the right axilla. The patient was subsequently initiated on antitubercular therapy. Cutaneous tuberculosis should be considered in the differential diagnosis of chronic or recurrent atypical cutaneous lesions in regions with a high burden of tuberculosis.