Coexistence of Tuberculosis Verrucosa Cutis with Scrofuloderma

Although cutaneous tuberculosis is rarely seen in developed countries, it is still commonly seen in developing countries. Tuberculosis verrucosa cutis (TVC) is a form of cutaneous tuberculosis that is caused by direct inoculation of Mycobacterium tuberculosis into the skin through open wounds or abrasions in sensitized individuals and is rarely seen in our country. Scrofuloderma is a form of cutaneous tuberculosis that occurs by direct spread of Mycobacterium tuberculosis from a contiguous structure. Coexistence of TVC and scrofuloderma is extremely rare. A 35-year-old woman presented to our clinic with a lesion on the dorsum of her left hand. Dermatological examination revealed verrucous, hyperkeratotic plaque on the dorsum of the left hand and fluctuating, purplish nodules and sinuses on the left axilla. The granulomas with caseation necrosis and Langhans type giant cells were seen in the histopathological examination of biopsy specimens obtained from the lesions on both the dorsum of the left hand and the left axillary lymphadenopathy. PPD was 20 mm. No tuberculous focus was detected in the patient. We present this case because coexistence of TVC and scrofuloderma is very rare.