Unusual Clinical Presentation of Cutaneous Tuberculosis Caused by Mycobacterium bovis

Cutaneous tuberculosis (CT) is rare despite the frequency of tuberculosis worldwide. CT is caused by the invasion of the skin by Mycobacterium tuberculosis, and less commonly Mycobacterium bovis or bacillus Calmette-Guérin (BCG). CT manifests a wide spectrum of clinical presentations. Lupus vulgaris (LV) is the most prevalent form of CT in Tunisia and has the most widely variable presentation of all forms of CT. Therefore, LV is considered to be one difficult diagnosis to make, especially in developed countries. We report a case of a 44 year old woman with multiple, annular LV caused by Mycobacterium bovis (M bovis) with emphasis on the diagnostic challenges of the disease.